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

The results of a study carried out on 32 patients with arterial hypertension about nephrotoxic effect obtained with a new non-ionic contrast agent have been reported. The diagnostic approach was based on the determination of the urinary excretion of two characteristic enzymes of the proximal tubule-epithelial cells (alfa-glycosidase and gamma-glutamil-transferase) and of a microprotein (beta-2-microglobulin) filtered by glomeruli and readsorbed and catalized by epithelial cells. The method used show an increased sensitivity and reliability in the early recognition of a kidney damage as well as in the control of anatomic and functional changes, in comparison with the classic parameters (azotemia, creatininemia). The results show a significantly lower enzymuric and microproteinuric level using non-ionic contrast media, also, in the patients at relatively higher risk of kidney damage. This results should be interpreted in favour to a lower potential nephrotoxicity of non-ionic contrast media and their elective use in the patients with a higher risk of kidney damage.
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PMID:[Renal contrast radiography study in hypertensive patients: comparison of the nephrotoxicity of ionic and non-ionic contrast media]. 666 40

The current approach to renovascular hypertension at the Lahey Clinic Medical Center consists of wider application of revascularization procedures than was possible a decade ago. Surgery is more frequently advised in patients over 50 years of age, in patients with atherosclerotic disease, and in patients with azotemia to restore renal function. Revascularization is suggested in some patients with a totally occluded renal artery, and alternatives to aortorenal bypass are advocated when the aorta is diseased. Bench surgery is used when appropriate, and concomitant aortic replacement and renal revascularization are generally avoid.
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PMID:Renovascular hypertension. Changing concepts in management. 670 Nov 11

Serial IgG analysis was performed on the urine and serum of 16 patients with pregnancy-induced hypertension. Significant immunoglobulinuria developed prior to the development of azotemia, significantly decreased creatinine clearance, significant proteinuria (greater than or equal to 3+ dipstick or greater than or equal to 5 gm per 24-hour urine collection), or oliguria. Nephelometric measurement of urine IgG concentrations appears to be a rapid and accurate method for confirming the severity of clinical disease, the degree of renal involvement, the benefit of treatment modalities on renal function, and the likelihood of postpartum maternal morbidity.
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PMID:Serial nephelometric urine IgG measurement and the management of pregnancy-induced hypertension. 671 42

A 45-year-old woman had abdominal pain, azotemia, and hypertension. Intravenous pyelography revealed bilateral ureteral compression by extrinsic tumor masses that proved to be neurofibromata by histologic examination. After surgical removal of the tumors, she became normotensive and asymptomatic. In addition, severe medial hypertrophy of veins was seen in the tissue examined. We believe that the latter is most probably related to the neurofibromatosis and is analogous to the hypertrophic arterial changes known to occur in patients with von Recklinghausen's disease.
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PMID:Retroperitoneal neurofibromatosis and venous anomalies. 677 34

Clinicopathologic features and follow up of 21 children with IgA nephropathy (Berger's disease) is discussed. The disease predominantly affected males. Although no definite prediction for any age group was observed, a majority (71.5%) of patient were six years or older. Macroscopic hematuria was the presenting feature in 71.5%, while as 28.5% had microscopic hematuria. Isolated proteinuria was not observed in any. 81% of the patients continue to have recurrent episodes of macroscopic hematuria, and 76% of the patients have microscopic hematuria during the symptom free intervals. Hypertension, azotemia and nephrotic syndrome were absent in all patients at the time of onset of the disease, and have not developed in any patient during follow up (mean 5.4 yrs). Serum IgA level elevated in only one (7.7%) of the thirteen patients in whom this was tested, and did not appear to be a diagnostic test of IgA nephropathy in children. The histologic features of renal biopsy did not correlate with known duration of the disease, extent of proteinuria at the time of biopsy or the degree of IgA deposits in the renal tissues. During childhood. IgA nephropathy appears to have an excellent prognosis, but longterm outlook can be projected only by following these children into adulthood.
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PMID:IgA nephropathy (Berger's disease) - a clinicopathologic study in children. 685 35

A woman, now 28 years old, was diagnosed 6 years ago as chronic glomerulonephritis by renal biopsy. From August 15, 1975 she complained of nausea, loss of appetite and weight (about 7 kg within 2 weeks). Severe hypertension (200/130 mmHg), hyponatremia (123 mEq/liter), anemia, elevated plasma renin activity (PRA), advanced azotemia, and eye ground changes of KW-II were found. Dialysis treatment was started on September 2, 1975. From November 1975 massive amounts of sodium (5,000 mEq or more monthly) and water (26 liters or more monthly) were removed by the dialysis. These intensive dialyses resulted in an elevated PRA with recurrence of severe hypertension. At the end of March 1976 she became almost blind with retinopathy of KW-IV. Potent hypotensive drugs including beta-blockers were administered, but no improvements were obtained. On March 31, 1976 nephrectomy was performed to save her life. Marked hyalinization of glomeruli and heavy thickening of intima in interlobular arteries were found in the removed kidneys. Renal artery stenosis was not recognized either macroscopically or histologically. In this patient, the amount of sodium removed by the dialysis was dependent on her diastolic blood pressure and sodium concentration of the dialysis. It may be concluded that too enthusiastic dialysis may develop malignant hypertension due to excessive renin release.
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PMID:Development of malignant hypertension in patients with uremia under hemodialysis: a case report and discussions on its etiology. 703 89

Twenty-seven patients with hypertension and varying degrees of renal failure were studied before and during the administration of frusemide. In 15 patients studies were repeated following the addition of propranolol. Mean exchangeable sodium was increased before the introduction of frusemide or propranolol in patients with azotemia, possibly due in part to the administration of other antihypertensive drugs, and was reduced to normal during frusemide treatment increasing slightly but significantly following the addition of propranolol. Blood pressure fell significantly with frusemide but there was no further significant fall with propranolol. The relationship of change in blood pressure to change in exchangeable sodium with frusemide did not reach significance. There was no relationship between changes in blood pressure and changes in plasma renin activity with frusemide, suggesting that the blood pressure response to frusemide is not limited by the rise in renin. The fall in blood pressure following the addition of propranolol was proportional to the dose of the drug but inversely proportional to the change in renin suggesting that renin levels are to some extent determined by the blood pressure response to propranolol rather than themselves determining that response. Serum creatinine was significantly increased during treatment with frusemide probably due to a combination of the effects of sodium depletion and the natural progression of the underlying renal disease rather than to nephrotoxicity. The further slight increase in serum creatinine following the addition of propranolol is in keeping with the reported effect of this drug on renal blood flow and glomerular filtration rate in patients without renal disease.
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PMID:The relative roles of sodium and renin in the hypertension of renal disease. An assessment based on the response to frusemide and propranolol. 703 75

All cases of surgically proven and cured primary hyperparathyroidism, over a five-year period, were reviewed for the presence of hypertension, renal and/or prerenal azotemia, nephrolithiasis, nephrocalcinosis, and patient symptom status. In this group of 23 patients, the prevalence of hypertension was greater than 78% (18 patients), which is statistically significant. Approximately 28% (5 patients) of the 18 hypertensive patients had some degree of azotemia and/or elevated serum creatinine. Most of the 23 patients were symptomatic, over the age of 50, female, and without nephrolithiasis or nephrocalcinosis. The possible etiologic mechanisms of calcium-mediated hypertension are discussed, and the important association of hypertension with primary hyperparathyroidism is emphasized.
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PMID:Hypertension and primary hyperparathyroidism: a five-year case review. 714 70

To identify any relationship between diabetes mellitus and high salt intake in the production of hypertension, we studied the effect of a regular and high salt diet on blood pressure in rats made diabetic with alloxan. The diabetic animals developed marked hyperglycemia, glycosuria, and azotemia out of proportion to changes in glomerular filtration rate. Non-diabetic rats and diabetic rats on a high salt intake in excess of 14 mEq/day developed modest but significant increases in blood pressure, while diabetic rats on a regular diet did not. We conclude that diabetic rats have no greater susceptibility to salt-induced hypertension than rats receiving only salt. Although it is possible that dehydration may have served to attenuate blood pressure increases in our diabetic animals, the diabetic state per se does not appear to result in severe hypertension in the rat regardless of sodium intake.
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PMID:Blood pressure of alloxan diabetic rats at regular and high salt intake. 724 77

The authors examined 9015 necropsies, over the age of 14, in a general hospital for the period January 1, 1967 to March 1, 1979. They found that the chronic pyelonephritis (ChPN) was the most frequent renal diseases with a lethal end--62.83 per cent of the renal patients and 7.95 per cent of all deceased. In 458 (63.87%) of them ChPN was accompanied by arterial hypertension (AH), which with an average duration of 8.8 years had caused a considerable hypertrophy of left ventricle. A better manifested atheromatosis of aorta, coronary, cerebral and renal arteries, being statistically significant, was found in the deceased with ChPN and AH as compared with the control group of 524 subjects, deceased without hypertension but that atheromatosis was less manifested than in those that died of hypertonic disease. That fact was explained by the authors with the shorter duration of hypertension in ChPN, with a more strict nutritional regimen among them, with the shorter life span and azotemia, as well as with the more active involvement of adrenergic systems of the patients with ChD. Whereas in 2/3 of the deceased with ChPN, without hypertension, the cause for the lethal end was uremia and urosepsis, the incidence of cardiac and cerebral-vascular complications, in those deceased with ChPN and AH, was 6 times greater than the first and uremia and urosepsis--considerably less frequent.
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PMID:[Incidence and the degree of cardiovascular changes and causes of death in 717 patient who died of chronic pyelonephritis with and without arterial hypertension]. 725 36


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