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

The author relates the data on the time-course of changes in diurnal proteinuria, diastolic arterial pressure and blood creatinine in 123 patients with primary chronic glomerulonephritis seen during 159 pregnancies. The dependence of the character of those changes on the respective parameters before conception was analyzed as was such a dependence, in part of the patients, on the morphological disease pattern. The rise of proteinuria and diastolic arterial pressure during gestation was seen more often in women with initial diurnal protein losses exceeding 1g and with arterial hypertension that occurred before pregnancy. The rise of blood creatinine before conception was a prognostically unfavourable sign. Mesangiocapillary glomerulonephritis occurring in the gestation period is viewed as less favourable as compared to mesangioproliferative glomerulonephritis.
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PMID:[The effect of pregnancy on the course of different clinical forms and morphological variants of primary chronic glomerulonephritis]. 221 23

In 70 patients with functionally compensated chronic glomerulonephritis (CGN), the disease outcomes were elucidated after the use of the 4-component therapy (a cytostatic, an anticoagulant, an antiaggregation agent and prednisone). The therapy appeared much more effective in the nephrotic types of CGN than in the active nephritic types. Remission was only attained in a subgroup of patients with the active types: with an early stage of the maximally active type of mesangiocapillary CGN. In the nephrotic type CGN, the therapy was effective in short-phase disease and ineffective in long persistence of that syndrome. In the nephrotic types, mesangioproliferative CGN as well as the short-phase nephrotic syndrome irrespective of the morphological type turned out predictors of a favourable outcome following the treatment. No effect can be predicted in focal segmental hyalinosis/sclerosis accompanied by arterial hypertension and the protracted nephrotic syndrome.
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PMID:[The catamnestic assessment of the efficacy of combined pathogenetic therapy in patients with different clinico-morphological variants of chronic glomerulonephritis]. 221 25

Renal survival curves for the adult patients at the ages between 15 and 60 with mesangial proliferative glomerulonephritis (MesPGN, N = 366) and membranoproliferative glomerulonephritis (MPGN, N = 76) were calculated using the method designed by Kaplan and Meier. In MesPGN, 80% and 68% of the patients survived 10 and 20 years after biopsy respectively; 88% and 72% survived 10 and 20 years after apparent onset. These results were similar to those analyzed by the research team "progressive renal lesions" in Ministry of Health and Welfare, Japan. When patients were histologically divided into 4 groups according to the index of glomerular lesions, % survival in each group was reduced in relation with the severity of the glomerular lesions, and there was significant difference between renal survival curves of each 2 groups. The influence of urinary protein and hypertension at the time of biopsy on survival curves was also significant. Patients with IgA nephropathy (N = 74) showed the renal survival curve similar to those of MesPGN. The influence of hypertension on % survival was also significant in IgA nephropathy. In MPGN, 53% and 73% of patients survived 10 years after biopsy and apparent onset respectively. Therefore MPGN was poorer in prognosis than MesPGN. These results seem to be important as the controls when we try to study the long-term effects of various therapies against chronic glomerulonephritis.
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PMID:[Prognosis of chronic glomerulonephritis--study on renal survival ratio of mesangial proliferative glomerulonephritis and membranoproliferative glomerulonephritis]. 226 26

A prognostic value of some clinical and morphological signs was followed up in 43 patients with chronic glomerulonephritis concurrent with the nephrotic syndrome versus 85 with other clinical types of the disease. There was a statistically significant incidence of disease progression in combination with arterial hypertension, resistance of the nephrotic syndrome over 12 months and detection of sclerosing renal glomeruli and interstitium within 2 years after onset of the disease. The protracted course of the nephrotic syndrome is a precursor of occurrence of chronic renal failure. With less prolonged phases of the syndrome there is evidence for a long-term period of functional compensation. Occurrence of arterial hypertension early in the disease, as early renal parenchymal sclerosis, fails to predict the rates of chronic renal failure development. In the absence of these factors, the possibility of prompt disease progression may be rejected in all likelihood.
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PMID:[Prognostic signs of accelerated progression of nephrotic types of chronic glomerulonephritis]. 229 Mar 44

Enzymuria is a frequent finding in patients suffering from various kidney diseases. The present study was undertaken to evaluate the clinical value of the determination of tubule-brush-border-associated dipeptidyl aminopeptidase IV (DAP IV) in the urine of patients with acute and chronic tubulointerstitial nephritis (n = 12), chronic glomerulonephritis (n = 15), essential arterial hypertension (n = 30), after kidney transplantation (n = 20), and of healthy control persons (n = 68). DAP IV was measured in spontaneously voided mid-stream morning urine ("second morning urine"), and was expressed as enzyme activity in units/liter. In order to account for variations due to urine concentration without collecting 24-hour specimens, a urinary DAP IV/creatinine ratio (DCR) was calculated. Furthermore, patterns of proteinuria were assayed by SDS-polyacrylamide gel electrophoresis. Urinary DAP IV activity of healthy controls was 4.94 +/- 0.12 U/l (DCR: 0.46 +/- 0.30 U/mmol creatinine) with only small day to day variations. Urinary DAP IV activity in patients with tubulointerstitial nephritis was significantly higher (15.5 +/- 15.6 U/l, p less than 0.05 vs controls; DCR: 1.67 +/- 0.97 U/mmol creatinine, p less than 0.001 vs controls). In patients with chronic glomerulonephritis urinary DAP IV activity was 9.6 +/- 5.6 U/l, p less than 0.05 (DCR: 1.22 +/- 0.75 U/mmol creatinine, p less than 0.05 vs controls). Increased urinary DAP IV activity in patients with chronic glomerulonephritis was associated with a mixed glomerulo-tubular pattern of proteinuria (as determined by SDS-PAGE).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Urinary excretion of dipeptidyl aminopeptidase i.v. in patients with renal diseases. 232 11

Excretion patterns of kidney related urinary proteins such as lysosomal beta-N-acetylglucosaminidase (beta NAG), brush-border Ala-(Leu-Gly)-aminopeptidase (AAP), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (AP) as well as of IgG, albumin, and alpha-1-microglobulin, were assessed in patients with chronic glomerulonephritis (n = 53), pyelonephritis (n = 27), systemic lupus erythematodes (n = 5), and patients with essential arterial hypertension (n = 18). Excretion of tubular marker enzymes and serumproteins (related to urine creatinine concentration = protein creatinine index) in spontaneously voided second morning urine was significantly higher as compared to the controls (n = 2). Alpha-1-microglobulin was markedly elevated in both pyelonephritis and glomerulonephritis indicating disturbance in tubulointerstitial handling of microglobulins also in cases with primary glomerulopathy. Rise of albumin, IgG, and alpha-1-microglobulin as well as of tubular kidney markers AAP, AP, GGT, and beta NAG in cases with arterial hypertension without preexisting nephropathy support the hypothesis of a defect in charge and size permselectivity in these patients which is probably due to an increase in glomerular capillary perfusion pressure and hyperfiltration.
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PMID:Kidney- and serum derived proteins in urine of patients suffering from renal diseases or arterial hypertension. 247 9

Prevalence of hypertension and relation of hypertension to renal function, type of glomerulonephritis or histological features were evaluated in 311 patients with idiopathic chronic glomerulonephritis. The overall prevalence of hypertension was 49.8%. At least in women, prevalence of hypertension was increased even at serum creatinine levels less than 1.1 mg dl-1 compared with the local general population. Prevalence of hypertension was 2.12 and 8.6 fold higher at serum creatinine 1.1-1.4 mg dl-1 in males and females respectively. In patients with untreated hypertension, a relation was found between mean blood pressure and subsequent decline of estimated GFR. Furthermore, in patients with arterial sclerosis, but not in patients without, a significant relation was found between blood pressure and subsequent increase in serum creatinine.
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PMID:Hypertension in chronic idiopathic glomerulonephritis: analysis of 311 biopsied patients. 249 76

Pathophysiological characteristics and long-term prognosis were studied retrospectively in 69 malignant hypertensives associated with grade III or IV retinopathy and the diastolic blood pressure greater than 120 mmHg. Thirty three (48%) cases had essential hypertension (EHT) as the underlying disease, 26 (38%) as chronic glomerulonephritis (CGN), and the remaining 10 (14%) as others including chronic pyelonephritis, renovascular hypertension, hydronephrosis, multiple calyceal diverticula, and unknown original disease. The role of the renin-angiotensin system in malignant hypertension was investigated by measuring plasma renin activity (PRA) and determining the blood pressure response to angiotensin (ANG)II antagonist, (Sar1, Ile8) ANG II. Basal PRA was significantly higher in the EHT group than the CGN group, and the ANG II antagonist-induced reduction of blood pressure was only evident in the former group. The regression analysis revealed that PRA was linearly correlated with both mean blood pressure (MBP) and serum creatinine prior to antihypertensive treatment in the EHT group but not in CGN patients, although there was inverse correlation between PRA and serum sodium in both groups. Therefore, the renin-angiotensin system seems to play a significant role in elevating blood pressure and deteriorating renal function in malignant hypertension developed from EHT, while it is less important in that from CGN. The 5-year survival rate was 90% in total 69 patients with malignant hypertension, while the 5-year renal survival rate defined as the probability of surviving without maintenance hemodialysis was 37%, indicating that the treatment with hemodialysis as well as antihypertensive drug therapy contributed to an improvement of prognosis of malignant hypertension. The EHT group showed a poor prognosis for life compared with the CGN group, while in the latter group most patients rapidly developed endstage renal failure. Although the pretreatment serum creatinine levels were matched, the renal function more rapidly deteriorated after development of malignant hypertension in the CGN group than did in the EHT group, indicating renal survival rate to be shorter in the former group. Hence, underlying diseases may affect the long-term prognosis of malignant hypertension. The results obtained from this study suggest that the pathophysiological characteristics of malignant hypertension are different and its long-term prognosis is varied by underlying diseases such as EHT and CGN.
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PMID:[Pathophysiology and prognosis in malignant hypertension: comparison by underlying diseases]. 251 35

Magnetic resonance tomography was performed to examine the kidneys, brain, adrenals, vessels, and heart in 110 patients with malignant arterial hypertension (MAH). The findings were compared with those of the examination of healthy subjects and patients with benign hypertensive disease (BHD). As compared to the controls, all the MAH patients had changes in the target organs, however, their nature and magnitude varied with under underlying MAH disease. Renal alterations were most profound in chronic glomerulonephritis. All the patients displayed signs of concentrated cardiac hypertrophy: its maximum degree being noted in renovascular hypertension, the least, in MAH of adrenal genesis. Examination of the central nervous system in MAH patients revealed that the ventricular system and subdural space were dilated. It was shown that it was feasible to diagnose hypertrophic encephalopathy in the prehospital period by employing magnetic resonance tomography.
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PMID:[Clinical use of magnetic resonance tomography in the assessment of vital organs in malignant arterial hypertension]. 253 95

Radioimmunoassay was used in 39 patients with chronic glomerulonephritis and secondary hypertension to measure atrial natriuretic peptide concentration in blood plasma. The latter concentration appeared unrelated to the patients' age, duration and gravity of hypertension, the degree of renal insufficiency, hyperhydration and activation of renin-angiotensin-aldosterone++ system. The conclusion is made on minor contribution of this short-acting peptide to pathogenesis of arterial hypertension in chronic glomerulonephritis.
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PMID:[The role of atrial natriuretic peptide in the pathogenesis of arterial hypertension in chronic glomerulonephritis]. 253 5


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