Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 76 patients with rheumatoid arthritis who had autopsies performed at the University of Utah and Salt Lake Veterans Administration Medical Center. The most common pathological finding in the kidney was interstitial fibrosis (46%) and internal proliferation of the arterioles in the absence of hypertension (54% of the cases). Renal amyloidosis was only found in 7% of the patients. Azotemia (creatinine above 2 mg/dl) was found in 9% of the patients but was not clinically significant. In addition uremia was not a frequent cause of death in patients with rheumatoid arthritis.
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PMID:Renal pathology in patients with rheumatoid arthritis. 730 Sep 97

In order to explore the effect of immunologically-induced nephropathy versus a non-immunological model on development of hypertension, rats with either Heymann nephritis or N,N'-diacetylbenzidine (N,N'-DAB)-induced nephropathy were subjected to DOCA-NaCl treatment. Hypertension developed during DOCA-NaCl treatment in Heymann nephritic rats but not in rats wih N, N'-DAB nephropathy, despite similar degrees of proteinuria and other features of nephrosis. There were no signs of different fluid balance, either. Azotemia did not ensue. Histology and immunohistology showed membranous glomerulonephritis in Heymann nephritic rats whereas glomerular epithelial cell alterations without immune deposits along the glomerular capillary walls were seen in rats with N, N'-DAB nephropathy. The type of renal damage or factors mediating such damage appear to be important determinants for the hypertensive response of Heymann nephritic rats to DOCA-NaCl treatment.
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PMID:Different blood pressure response to DOCA-NaCl treatment in autoimmune and N,N'- diacetylbenzidine-induced nephropathies. 731 56

Progressive osteolysis with disappearance of the carpal and tarsal bones occurs as a rare syndrome associated with a serious nephropathy. The characteristic skeletal changes have an onset in early childhood and precede renal failure by 10--15 years. The present case, the ninth reported in the world literature, was a 22-year-old, white female who presented with carpal and tarsal swelling at age 2. Severe hypertension and azotemia were present when the patient died of pneumonia and extracellular fluid volume depletion. At necropsy, the kidneys weighed 55 g each. Microscopy showed proliferation of vascular intima and medial hypertrophy of renal vessels of all sizes. Tubulointerstitial and glomerular changes are probably secondary to the severe vascular disease. Although similar skeletal lesions can be seen in kindred with autosomal dominant and recessive inheritance, all reported cases of nephropathy including the present one are sporadic.
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PMID:Nephropathy of idiopathic multicentric osteolysis. 736 Feb 98

Battered child syndrome, a not uncommon problem, may involve deep structures including the liver, spleen, and brain. While involvement of kidneys is extremely rare, such an association is illustrated by the following case which presented with azotemia and hypertension. Management should depend on the degree of renal failure and hypertension as well as the extent of any electrolyte imbalance.
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PMID:Acute renal failure in battered child syndrome. 737 61

A total of 15 patients with renovascular hypertension underwent revascularization of totally occluded renal arteries. Preoperative clinical assessments suggesting renal salvageability include urographic visualization of the involved kidney, renal length greater than 9 cm., filling of the distal renal arterial tree on angiography and elevated renal vein renin levels. Postoperatively, hypertension was cured or improved in 14 patients and there was 1 failure. Over-all renal function improved in 9 of 10 patients with preoperative azotemia and stabilized in the remaining 5 patients. Revascularization can be done successfully in properly selected patients with complete renal artery occlusion, with control of hypertension and reversal of renal failure.
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PMID:Renal revascularization in patients with total occlusion of the renal artery. 740 Dec 28

High dosages of nephrotoxic drugs in elderly patients might be correlated with an increase in the number of patients with tubulo-interstitial nephritis (TIN). In patients with acute TIN, marked fever, back or flank pain, CVA tenderness, skin rash, arthralgia, eosinophilia, and eosinouria are observed. Clinical symptoms might be induced by glomerular, proximal tubular or distal tubular dysfunction in chronic TIN. Mild to moderate proteinuria, edema, hypertension, azotemia, glucosuria, aminoaciduria, polyuria and polydipsia are characteristic findings in patients with chronic TIN. These findings are slowly progressive in such patients. It appears that the marked fibrosis with lymphocyte infiltration in the interstitium is a poor clinical marker in patients with TIN. Furthermore, it is important to differentiate TIN from glomerulonephritis.
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PMID:[Symptoms in patients with tubulo-interstitial nephritis]. 756 29

Chronic renal infection (Chronic bacterial pyelonephritis) is a cause of tubulo-interstitial nephropathy (nephritis); TIN. The disorder causes end-stage renal failure in about 2% of the patients who are treated by dialysis. However, Chronic bacterial pyelonephritis is a relatively benign condition that seldom leads to renal function loss. The affected kidney shows non-specific histological pictures similar to that seen with other diseases producing TIN. Clinical symptoms are of ten vague. Obstructive uropathy (eg, stones, benign prostatic hyperplasia) is frequently present. The affected kidney, which is almost unilateral, shows atrophy and scarring of variable degree. Significant pyuria and bacteriuria may or may not be found. Depending on the stage of the disease, the serum creatinine and blood urea nitrogen may be normal or elevated. Contributing obstructive uropathy should be corrected. The patients must be followed closely, urinary tract infection must be controlled and complications (eg, hypertension, azotemia) must be identified promptly and treated adequately.
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PMID:[Interstitial nephropathy due to chronic bacterial pyelonephritis]. 756 35

Late-onset renal failure occurs in up to 20% of survivors of bone marrow transplantation. Total body irradiation is a major factor in this syndrome, so-called bone marrow transplant nephropathy (BMT NP), which is defined by disproportionate anemia, hypertension, and azotemia. Previous or concurrent chemotherapy may potentiate the effect of radiation on the kidney. Kidney function may decline acutely or more gradually, with eventual long-term stabilization. Patient survival is associated with control of the blood pressure. BMT NP is a recognized complication of bone marrow transplantation, which will require ongoing attention.
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PMID:Bone marrow transplant nephropathy: radiation nephritis revisited. 756 7

Are there differences in the patient characteristics and clinical outcome for transaortic renal endarterectomy vs. bypass grafting when either technique is combined with infrarenal aortic replacement for occlusive or aneurysmal disease? Two common perceptions persist: (1) combined aortic and renal procedures have a high risk and (2) bypass is easier and safer than endarterectomy. To address these controversies we compared 52 consecutive patients undergoing concomitant aortic and renal reconstruction between 1987 and 1991: 26 with bypass and 26 with endarterectomy. Bypass patients were older (70 vs. 64 years, p = 0.001), had more extensive plaque extending into the distal renal artery and more severe baseline azotemia (creatinine = 2.6 vs 1.7 mg/dl, p = 0.01), more clinically evident coronary heart disease (89% vs. 56%, p = 0.001), and a greater need for nephrectomy of a small nonfunctional pressor kidney (23% vs. 0%) than endarterectomy patients. In contrast, endarterectomy patients more commonly required aortic replacement for occlusive disease than for an aortic aneurysm (endarterectomy: 65% vs. 35%; bypass: 19% vs 81%, p = 0.002) and tended to require more intraoperative technical revisions (12% vs. 4%) than bypass patients. Both groups, however, experienced no operative mortality, had similar cardiorespiratory morbidity, and achieved equal improvement in hypertension (69% vs. 65%). Bypass patients, who already had more severe preoperative azotemia than endarterectomy patients, showed less improvement in the creatinine level (Cr = 2.1 vs. 1.4 mg/dl, p = 0.01) and had greater need for late dialysis (30% vs. 4%, p = 0.01). Only one patient on dialysis had graft occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal endarterectomy vs. bypass for combined aortic and renal reconstruction: is there a difference in clinical outcome? 770 67

Hemolytic uremic syndrome (HUS) is defined as microangiopathic hemolytic anemia, thrombocytopenia and uremia. It is an important cause of acute renal failure (ARF) in children all over the world. The present study was carried out to assess the incidence, clinical presentation, hematological and biochemical profile of children presenting with HUS from 1987 to 1990. Out of the 100 cases who presented with ARF 22 had HUS. A majority of these children were males below 1 year of age, and had a prodromal phase of mainly gastrointestinal manifestations lasting for about a week. Anemia was a constant feature followed by bleeding diathesis, mainly melena and purpura. Neurological manifestations included altered sensorium, irritability, coma, hypertensive encephalopathy and convulsions. Renal problems mainly included oliguria, hypertension, hematuria and edema. Investigations revealed thrombocytopenia and microangiopathic hemolytic anemia in all cases. Evidence of disseminated intravascular coagulation (DIC) was observed in 3 cases as decreased fibrinogen levels, increased fibrinogen degradation products and deranged clotting studies. Blood biochemistry revealed azotemia in all cases, hyponatremia in 5 cases, hypernatremia in 3 cases and hyperkalemia in 12 cases. Stool culture showed the presence of Shigella in 8, E. coli in 6 and Klebsiella in 4 cases. Out of 22 cases of HUS, 15 were treated conservatively; of these 2 died. Both of these deaths were due to DIC 7 children were put on peritoneal dialysis; only 1 child died in this group. Factors affecting the outcome were duration of oliguria, levels of blood urea and presence of encephalopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A clinico-hematological profile of hemolytic-uremic syndrome. 788 99


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