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

Rapidly progressive glomerulonephritis frequently leads to death or dialysis. In 21 cases treated by plasma exchange and immunosuppression we observed seven deaths, with 12 others progressing to chronic renal failure within 3 months. Patients who died were older than those who survived (57.5 +/- 17.7 vs 40.5 +/- 16.5 years, mean +/- SD, P = 0.05), but had similar clinical symptoms (hypertension, haematuria, proteinuria, extrarenal signs) and biochemical presentation (initial creatininaemia). They required the same degree of haemodialysis, of plasma exchanges and of bolus methylprednisolone. The causes of death were infection (three cases), cardiac arrhythmia (two cases) and gastrointestinal bleeding (two cases). Among the 14 remaining patients, only two recovered normal renal function. Twelve had chronic renal failure, six of them requiring chronic dialysis or transplantation. Severe renal failure at entry and anuria were more frequently observed in patients whose renal function did not improve during treatment. Plasma exchange and steroid bolus infusions also seemed to have a beneficial effect on renal function.
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PMID:Plasma exchange and immunosuppression for rapidly progressive glomerulonephritis: prognosis and complications. 249 77

Rapidly progressive glomerulonephritis (RPGN) is rarely associated with macroscopic polyarteritis nodosa (PAN), as seen in this series of 7 out of 235 patients. The clinical symptoms of PAN were as follows: myalgias 6; fever 1; arthralgias and mononeuropathy multiplex 5; cutaneous vasculitis 3; arterial hypertension 4, 3 of which were malignant. The mean proteinuria was 2.7 g/24 h; creatininemia 458 microM/l; microscopic hematuria was present in 4 of the 7 patients; only 1 patient was anuric. Markers of hepatitis B virus were absent in all cases. Arteriography revealed microaneurysms and renal infarcts in 6 patients and distal arterial stenosis in one. Renal biopsies from all 7 patients demonstrated extracapillary glomerulonephritis, which was associated with tubulointerstitial fibrosis in one. Necrotizing vasculitis lesions were associated in 5 cases. Immunofluorescence was positive in 5 cases. The association of RPGN and PAN exists and may be underestimated due to the lack of systematic angiographic examinations during RPGN and renal biopsies in PAN patients with renal involvement.
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PMID:[Rapidly progressive glomerulonephritis in macroscopic periarteritis nodosa. 7 cases]. 790 9

Rapidly progressive glomerulonephritis is rare but severe clinical syndrome, which results in end-stage renal disease if not treated. The prognosis can be improved with early diagnosis and aggressive treatment. The aim of our study was to analyze retrospectively all cases of rapidly progressive glomerulonephritis, diagnosed in Kaunas University of Medicine Hospital since 1996 and to evaluate the clinical, laboratory, immunological, pathomorphological data, treatment and outcome in these patients. In period of 1996-2002, 23 patients were treated in Departments of Nephrology, Rheumatology, and Pediatric Nephrology. Rapidly progressive glomerulonephritis was observed in elderly persons, the mean age 46.48+/-5.28 years. In 21.74% of cases, patients were diagnosed Goodpasture syndrome, in 21.74% of cases immune complex disease and in 56.52%--pauci immune glomerulonephritis which was mainly limited in kidney as necrotizing crescentic glomerulonephritis. Rapidly progressive glomerulonephritis in most cases manifested by weakness, hypertension, fever, involvement of lower airways, infection. Renal biopsies were performed in 18 (78.26%) cases, lung biopsy was made for one patient. Biopsies were made on 30.56+/-7.41 day of hospitalization. Twenty-two (95.65%) patients received intravenous pulses with methylprednisolone and/or cyclophosphamide; 56.52% patients required dialysis. Renal function improved in 47.83% patients; 8 (34.78%) patients died. The causes of death were infections complications, progression of main disease and cardiac arrest.
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PMID:[Rapidly progressive glomerulonephritis syndrome: course, pathomorphology and outcome (data of Kaunas University of Medicine Hospital 1996-2002)]. 1276 18