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)

A total of 29 patients with chronic renal insufficiency (CRI) were investigated. Noticeable disorder of erythrocytic deformability (ED) was detected in half of them. The expression of arterial hypertension showed correlation with a degree of ED disorder. A possibility of the main role of ED disorder in the development and progression of arterial hypertension was discussed. ED disorder was found to correlate with a degree of expression of laboratory signs of the DIC-syndrome and was practically unassociated with the blood level of creatinine.
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PMID:[Relation between arterial hypertension and disorder of erythrocyte deformability in patients with chronic renal failure]. 320 74

Between 1975 and 1985, 43 patients underwent simultaneous aortic and renal artery reconstruction. Twenty-two patients had infrarenal abdominal aortic aneurysms and 21 had aortoiliac occlusive disease. In addition, 40 patients had severe lesions of one or both renal arteries and three patients had a lesion in an accessory renal artery. Hypertension was present in 29 patients, 15 of whom had impaired renal function. Four patients had chronic renal insufficiency without hypertension. Ten patients underwent prophylactic renal artery reconstruction. Infrarenal aortic repair was carried out simultaneously with thromboendarterectomy of one or both renal arteries, or reimplantation of a renal artery into the aorta, in two cases with contralateral nephrectomy. In one patient, the celiac and superior mesenteric arteries were also bypassed. Three patients (7%) died in the immediate postoperative period, two of these from myocardial infarction. Long-term survival was studied in 37 patients. Sixty-seven percent of patients with preoperative hypertension and less than 50% of those with preoperative renal insufficiency had good results.
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PMID:Atherosclerotic lesions of the aorta and renal arteries: results of simultaneous surgical treatment. 322 60

The clonidine withdrawal syndrome occurs in at least 1.2% of patients following withdrawal of the drug. Its frequency is influenced by length of treatment, daily dosage and degree of hypertension. The combination of clonidine with beta blockers favours the development of hypertensive crisis following clonidine withdrawal. The case is presented of a 49-year-old female who had had chronic renal insufficiency and hypertension for several years and who developed a hypertensive crisis after cessation of therapy with clonidine and nadolol. An overshoot hypertension after clonidine withdrawal should be treated with vasodilatatory drugs such as nitroprusside; calcium antagonists and ACE inhibitors also offer a possible new approach. It is advisable to reduce the clonidine dose slowly, and combination with labetalol or calcium antagonists during clonidine withdrawal seems to have favourable results. Beta blockers should be discontinued well before the cessation of clonidine treatment.
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PMID:[Hypertensive crisis after withdrawal of clonidine and nadolol. Case report and review of the literature]. 330 14

Heart transplantation represents a widely accepted therapeutic modality for patients with end-stage myocardial failure. With increasing experience, 1-year survival rates of over 75% and 5-year survival rates of over 60% have been achieved, mainly due to patient selection, standardized surgical techniques as well as improved postoperative management. During early follow-up, particular attention should focus on diagnosis and treatment of graft rejection and infection, which require individualized immunosuppression, while in the later postoperative course coronary atherosclerosis, hypertension, chronic renal insufficiency and malignancy become more important as potential complications. The general principles in the management of these patients are discussed.
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PMID:[Heart transplantation--postoperative management]. 330 15

The authors' and literature data on hormonal imbalance in uremia are analysed. The pathogenesis, clinical and laboratory signs and present-day methods of correction of renal osteodystrophy, anemia, arterial hypertension, derangements of carbohydrate and lipid metabolism, and hypogonadism developing as complications of chronic renal insufficiency (CRI), are considered. Increased potentialities of pharmacological correction of the above endocrine disturbances in CRI have been shown.
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PMID:[Current possibilities of correction of hormonal imbalance in uremia]. 344 81

Captopril, an inhibitor of the conversion enzyme, is a medication with a known efficacy in the treatment of arterial hypertension and congestive cardiac insufficiency. Its side-effects are few. Among them, agranulocytosis is a severe complication, all the more severe and frequent as it occurs in patients with chronic renal insufficiency, collagen disease, or patient treated with medication having a leucopenic potential. Our case reports an agranulocytosis secondary to captopril in a patient with cardiac insufficiency presenting none of these aggravating factors. The mechanism of agranulocytosis secondary to captopril remains currently debatable, but does not seem, in the present case, to be dose related. Thus, a captopril prescription must comply with certain rules; decrease of the dosage in case of renal insufficiency, usual precautions in patients with collagene diseases. The association to a medication with leucopenic potential is to be avoided. Hematologic monitoring will be adapted to each particular case.
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PMID:[Agranulocytosis caused by captopril]. 354 68

To define the benefits and risks of renal revascularization or nephrectomy in patients with both severe hypertension and chronic renal insufficiency, we analyzed 98 patients who underwent renovascular operations after serum creatinine levels exceeded 2 mg/dl. This subset of patients was selected from a retrospective review of 652 renal operations performed at the Mayo Clinic for renovascular disease between 1970 and 1981. Special attention was given to the type of operations, their effect on hypertension and renal function, specific factors that affected operative deaths, and late survival. Unilateral renal operations were performed in 48 patients with bilateral procedures in 50. Simultaneous aortic reconstruction was necessary in 55 patients (56%). Postoperative diastolic blood pressure was less than 90 mm Hg in 55% of patients and 90 to 100 mm Hg in an additional 33%. Seventy-six percent of patients required less antihypertension medication. Serum creatinine improved or stabilized in 69%. Ninety percent of patients avoided any early or late renal dialysis. The operative mortality rate was 7.1% and tended to be higher in patients with a serum creatinine greater than 3 mg/dl and in those with past myocardial infarction (p = 0.05). The late survival rate was 64% at 5 years. The main cause of operative and late death was myocardial infarction. In conclusion, most patients with renovascular hypertension and early chronic renal insufficiency can be benefited by surgical revascularization or nephrectomy. Future improvement in early and late survival may require a more aggressive approach to the identification and correction of significant coronary artery disease.
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PMID:Renovascular operations in patients with chronic renal insufficiency: do the benefits justify the risks? 356 Mar 55

Microdissection of nephrons of kidneys of children showing advanced ischemic tubular atrophy, and removed for control of hypertension, demonstrates marked proximal convoluted tubular atrophy, with formation of multiple small proximal tubular diverticula. These diverticula presumably contribute to the microscopic appearance of large numbers of small tubules lined by low epithelial cells with pale or clear cytoplasm, adjacent to glomeruli in the cortices of kidneys showing ischemic tubular atrophy (endocrine kidney). Segmentation of such atrophic tubules leads to formation of blind segments (microcysts), as demonstrated in this study and by Oliver. The distinctive microscopic appearance of the endocrine kidney, a not infrequent finding in kidneys of children with chronic renal insufficiency who require nephrectomy for control of hypertension, has not hitherto been emphasized in the literature on pediatric renal disease.
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PMID:Microdissection demonstration of the lesion of the endocrine kidney in children. 372 6

The kinetics and short-term (10 weeks) effects of trimazosin, an alpha 1-adrenoreceptor antagonist, on renal function and blood pressure in patients with moderate chronic renal insufficiency and hypertension, have been studied for the first time. Eight patients in whom the blood pressure was not normalized with a diuretic alone underwent pharmacokinetic studies and assessment of the renal function during a 10-week period of trimazosin therapy. Trimazosin significantly lowered blood pressure (recumbent and upright) without significantly altering renal function. Renal vascular resistance was decreased by 14%. Fractional sodium excretion, proteinuria and laboratory serum tests remained unchanged. Neither body weight nor pulse rate were affected. Moderate renal insufficiency did not modify the pharmacokinetics of the drug. Thus, trimazosin, as second-step antihypertensive agent, appeared to be safe and effective in patients with moderate renal insufficiency and hypertension, without exerting favourable or adverse renal effects during short-term therapy.
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PMID:Pharmacokinetics of trimazosin and its effects on blood pressure, renal function and proteinuria during short-term therapy of patients with impaired renal function and hypertension. 378 Aug 29

Diuretics have been used in acute renal failure in an attempt to increase urine flow and ameliorate the reduction in glomerular filtrate rate. A beneficial response occurs in some experimental models of acute renal failure when diuretics are administered prophylactically or very early in the course of renal failure and may require a renal vascular bed capable of responding partially, at least, to vasodilating stimuli. In chronic renal insufficiency the most important indications for diuretic use are for the treatment of systemic hypertension and for the correction of the congested state. However, the precise effect of diuretic therapy under these conditions is unpredictable and dependent on the functional state of the renal vessels. Diuretic administration may at times prove detrimental, resulting in a deterioration of glomerular filtration rate. In hemodynamically unstable conditions the slow removal of extracellular fluid by continuous arteriovenous hemofiltration may prove preferable to diuretic administration or standard forms of dialysis.
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PMID:The effect of diuretics on systemic and renal hemodynamics in patients with renal insufficiency. 388 5


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