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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The dependence of actuarial survival rates on morphological and clinical manifestation of chronic glomerulonephritis (CGN) has been studied in 520 patients followed up for 2-42 years. In grouping the patients along two signs--histological lesion and relapse incidence--the survival in different morphological forms of CGN was found to be similarly dependent on the illness activity. It was high in rare and the lowest in frequent and persisting relapses. Hypertension, high-grade tubulo-interstitial changes and sclerosis over 50 per cent of glomeruli indicate a poor prognosis as signs of severe renal damage under which each relapse may hasten the lethal outcome. Identification of the histological appearance is of high importance in CGN prognosis because of their different manifestations and tendency to relapse.
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PMID:Long-term prognosis of chronic glomerulonephritis. 193 21

Several reports in animals, and sporadic case reports in humans, have suggested that kidneys with decreased nephron mass may be more susceptible to the development of focal-segmental glomerosclerosis. This prompted a reexamination of our previously reported group of pediatric donor-adult recipient renal transplant combinations. Data were analyzed from 31 adult recipients who had received renal transplants from cadaver pediatric donors (less than 6 years) with graft function for greater than 6 months and no evidence of chronic rejection. These were compared with a control group transplanted during the same period with adult donor kidneys. Immunosuppression consisted of azathioprine/prednisone or quadruple therapy in 16 and 15 patients respectively. End-stage renal disease (ESRD) was secondary to chronic glomerulonephritis (n = 9), diabetes mellitus (n = 6), polycystic kidney disease (n = 5), and miscellaneous causes (n = 11). Twenty patients had radiographic documentation of renal hypertrophy posttransplant. All patients had serial 24-hr urinalysis for protein and creatinine after transplantation during periods of stable renal function. Ten patients had renal biopsies performed at a mean time from transplant to biopsy of 10.4 +/- 1.6 months. Seven recipients had biopsies that revealed glomerulosclerosis at 13 +/- 6 months posttransplant. Protein excretion and serum creatinine in these patients were significantly higher than in control patients (1.6 +/- 0.37 vs. 0.49 +/- 0.15 g/24 hr and 1.96 +/- 0.11 vs. 1.64 +/- 0.09 mg%; P less than 0.03 and P less than 0.01, respectively). Only 3 of 25 control adult donor recipients developed proteinuria greater than 0.8 g/24 hr within 2 years of transplantation vs. 15/31 pediatric donor recipients. No correlations with the etiology of ESRD, age (greater than or less than 40 years), weight, sex, diabetes, hypertension, or the number of acute rejection episodes could be found. Our data suggest that adult recipients of pediatric donor renal transplants may be at greater risk for the development of glomerulosclerosis than those recipients receiving adult donor kidneys.
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PMID:The development of proteinuria and focal-segmental glomerulosclerosis in recipients of pediatric donor kidneys. 194 66

Whether or not pregnancy adversely affects the natural course of underlying primary renal disease, and whether fetal outcome is influenced by the type of renal disease per se are controversial issues. We retrospectively analyzed the fetal and maternal outcome in 148 women with various, biopsy-proven histological types of primary chronic glomerulonephritis (GN), including IgA GN (52 patients), membranous GN ([MGN] 20 patients), membranoproliferative type 1 GN ([MPGN] 58 patients), focal and segmental glomerulosclerosis ([FSGS] 13 patients), and minimal change nephrotic syndrome ([MCNS] 22 patients), who were pregnant (with a total of 290 pregnancies) after the clinical onset of GN, and in 104 women with reflux nephropathy (with a total of 254 pregnancies). Fetal outcome was poor in the presence of uncontrolled hypertension, nephrotic range proteinuria, and/or impaired renal function at conception or early in gestation, whatever the type of renal disease. An accelerated, more rapid than expected, worsening of maternal renal function was observed in five GN patients of whom four (two IgA, two MPGN) had serum creatinine (Scr) levels greater than 160 mumol/L (1.8 mg/dL) early in gestation, and in five patients with reflux nephropathy whose Scr at conception ranged from 180 to 490 mumol/L (2.0 to 5.5 mg/dL).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Specific controversies concerning the natural history of renal disease in pregnancy. 199 51

A review of continuous ambulatory peritoneal dialysis (CAPD) performed at one facility over a period of 10 years showed that age and type II diabetes mellitus were associated with the worst technique survival. The median survival of patients entering CAPD was not significantly different when the etiology of renal failure was chronic glomerulonephritis (CGN; 27 months), chronic interstitial nephritis (CIN; 21 months), diabetes mellitus type I (21 months), or hypertension (16 months). Patients with diabetes mellitus type II had significantly (P less than 0.05) worse survival (11 months). A patient remaining on CAPD 6 months had a 55% to 60% chance of remaining on therapy at 2 years and a 47% chance at the end of 3 years, whereas a patient with diabetes mellitus type II had a 34% conditional probability of remaining on dialysis at 2 years and 18% at 3 years. Sex, race, and educational achievement were not important determinants of dialysis technique survival. Studies are indicated to identify predictors of a poor dialysis experience.
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PMID:Continuous ambulatory peritoneal dialysis: ten years at one facility. 199 57

Monotherapy with calcium antagonists nifedipine, foridon and verapamil hydrochloride was assessed in 46 patients with chronic glomerulonephritis and arterial hypertension by hypotensive effect and changes in systemic and renal hemodynamics, water-electrolytic balance, renin-angiotensin system. It is shown that nifedipine and foridon act as peripheral vasodilators. A hypotensive effect manifested most potently in nifedipine administration. None of the drugs aggravated renal hemodynamics, elevated intraglomerular tension, activated renin-angiotensin system, promoted water and sodium retention. Calcium antagonists are thought a treatment of choice in management of nephrogenic hypertension.
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PMID:[Calcium antagonists in the treatment of nephrogenic hypertension]. 208 71

The kallikrein-kinin system of the blood serum (prekallikrein and kallikrein) was studied in 68 patients with chronic glomerulonephritis with the purpose of determining the significance of this system in the origin of proteinuria, protein content in the morning portion of urine and 24-hour portion. Linear correlation analysis revealed a direct relation of the levels of kallikrein and prekallikrein in the blood serum the morning and 24 losses of protein in patients suffering of glomerulonephritis with an isolated urinary syndrome (18 patients), nephrotic (27 patients) and glomerulonephritis with arterial hypertension.
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PMID:[THe role of the kallikrein-kinin system in the origin of proteinuria in glomerulonephritis]. 208 9

The present study was carried out to test the hypothesis that the familial risk of hypertension is elevated in individuals with glomerulonephritis. Sixty-three parents of 39 consecutive patients below the age of 50 years who were admitted with biopsy-confirmed primary glomerulonephritis (excluding familial glomerulonephritis) were examined. Of these parents, 57% had blood pressure greater than or equal to 160/95 mmHg and/or were taking antihypertensive medication (81% of hypertensives). In 138 parents of 87 controls (age- and sex-matched patients admitted to a surgical ward for trauma), hypertension was found in 32.6% (of whom 73% were on antihypertensive medication). Age, sex ratio and body mass index were comparable in both groups of parents. A similar proportion of parents of patients with glomerulonephritis (27%) and parents of controls (25%) had already died. There was no evidence of excess cardiovascular or renal mortality in either group of parents. Urinary abnormalities were found in a similar proportion of the parents of patients with glomerulonephritis (5%) and controls (8%). Although the effects of a shared environment are not formally excluded, the data are consistent with a possible increased genetic risk of hypertension in patients with primary chronic glomerulonephritis.
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PMID:Increased genetic risk of hypertension in glomerulonephritis? 216 92

This review focuses on the reciprocal influence of underlying primary glomerular disease on fetal outcome and of pregnancy on the course of maternal nephropathy, based on most recent data in the literature and on a personal series of 240 pregnancies in 122 women with biopsy-proven chronic glomerulonephritis (CGN) followed at Necker Hospital. The first part analyzes the fetal outcome in the various histopathologic types of CGN and points out the major influence as risk factors for fetal outcome, of the presence of nephrotic syndrome, high blood pressure and/or impaired renal function at conception. The second part deals with the debated problem of the influence of pregnancy on maternal renal disease. It has become evident that pregnancy has no deleterious effect per se on the course of maternal disease when renal function is normal or near normal at conception, whereas an accelerated course is often observed when plasma creatinine is in excess of 0.18 mmol/l at conception, whatever the type of CGN. In the third part are described preconception counselling and the practical rules of maternal and fetal surveillance.
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PMID:[Fetal and maternal risk of pregnancy in women with primary chronic glomerulonephritis]. 220 24

A total of 42 patients with malignant arterial hypertension (MAH) were examined. Of these, 32 patients had essential hypertension (26 with normal renal function and 6 with renal failure treated by programmed hemodialysis) and 10 suffered from chronic glomerulonephritis. The patients were examined for central hemodynamics, hormonal background (plasma renin activity) (PRA), plasma aldosterone and cortisol concentration. 14 patients underwent closed puncture biopsy of the kidneys. All the patients manifested high PRA associated activation of gluco- and mineralocorticoid adrenal function along with the hyperkinetic syndrome. MAH was characterized by dramatic discrepancy between the stroke and cardiac indices and specific peripheral resistance. Nephrosclerosis whose extent varied, attaining maximum in patients with associated essential hypertension and renal failure and in autopsy material, in addition to severe lesions of the renal vessels appeared to be the common feature of all morphological alterations. Plasmic impregnation and fibrinoid necrosis of the arterioles were not detectable in all the patients, being of focal character. The same alterations were identified in the patients during exacerbation of glomerulonephritis and in the absence of MAH. The data obtained point to the nonuniformity of MAH. Four clinicomorphological variants of MAH are suggested.
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PMID:[The malignant hypertension syndrome: incontrovertible and questionable truths]. 221 9

In 520 patients followed up for 4 to 20 years a study was made of the relationship between the actual survival time and the morphological and clinical characteristics of chronic glomerulonephritis. A well-defined parallelism was established between the rate of disease progress and the rate of exacerbations as was an unfavorable prognostic importance of marked tubulointerstitial lesions and glomerular sclerosis, which was more manifest in frequent relapses. Considerable differences in the survival of patients with hypertension or associated hypertension and the nephrotic syndrome with varying process activity do not provide evidence in favour of their direct influence on the rate of the disease progress. As far as certain morphological patterns of glomerulonephritis are concerned, the prognosis is different because of specific clinical manifestations and anatomic alterations common to each disease pattern.
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PMID:[The prognostic significance of the morphological and clinical characteristics of chronic glomerulonephritis]. 221 21


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