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

The acute and chronic antihypertensive effects of nifedipine were investigated in patients with chronic renal insufficiency (CRI). The acute effects were assessed after the administration either of a fast-release nifedipine capsule or a slow-release nifedipine tablet in 10 and 15 patients respectively. Both the preparations induced prompt and marked reduction of systolic and of diastolic blood pressure, but the capsules showed a shorter antihypertensive effect (2 hours) than tablets (more than 6 hours). The chronic effects of nifedipine tablets given in addition to the previous therapy was assessed in 25 patients with CRI and resistant hypertension. Both systolic and diastolic blood pressure values promptly fell and maintained within the normal range over the whole period of the study (12 months).
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PMID:Treatment of arterial hypertension with nifedipine in patients with chronic renal insufficiency. 397 81

It has been shown that latent renal diseases are detected by sectoral scintigraphy earlier than by other methods, and the former acquires particular importance when the only sign of disease is arterial hypertension. Early diagnosis of latent pyelonephritis makes this method especially valuable both for the selection of patients for further thorough examination and for the start of adequate therapy. Scintigraphy serves as a reliable criterion for the evaluation of the therapeutic efficacy in patients with chronic pyelonephritis (CP). Changes of scintigraphy parameters coincide quite exactly with the changed level of arterial pressure, concentration and nitrogen clearing function of the kidneys during treatment. This method (sectoral scintigraphy) is very important when used over time in CP patients with chronic renal insufficiency making it possible to detect with a sufficient degree of significance the improvement as well as impairment of renal function which is a crucial point for the choice of further therapeutic tactics.
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PMID:[Dynamic scintigraphy of the kidneys during chronic pyelonephritis in patients with arterial hypertension]. 398 54

The calcium, magnesium, and cyclic AMP content and 45Ca transport in the aorta and iliac artery and the mechanical properties of these vessels were studied in rats with experimental renal insufficiency. The development of hypertension was attended by an increase in the magnesium content in the vascular wall, a certain decrease in the cyclic AMP level, marked disturbance of 45Ca transport, and changes in the mechanical properties of the vascular wall. The use of dihydrotachysterol or a complex of sex steroids which correct calcium metabolism led to a decrease of arterial hypertension. It is suggested that disorder of calcium metabolism in chronic renal insufficiency plays an essential role in the inadequate regulation of the vascular tone and the development of hypertension.
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PMID:[Cyclic 3,5-adenosine monophosphate content and calcium transport in the aorta in hypertension due to experimental renal insufficiency]. 624 5

Selective bilateral renal artery embolization was performed in 5 patients because of severe hypertension not responding to conventional medical treatment, in two patients on repeated dialysis; severe nephrotic syndromes with chronic renal insufficiency in the three other patients. A significant drop in blood pressure occurred in only two of the hypertensive patients, about 40 days after embolization. Bilateral surgical nephrectomy was required in the other patient because of persistence of residual vascularization and high RAP. Excellent results were obtained in the 3 patients with a nephrotic syndrome, with disappearance of proteinuria and anuria following the embolization. For this method to be effective, the arterial obliteration has to be complete and definitive. When symptoms persist or there is a relapse, especially in the cases with hypertension, a repeated arteriographic examination and complementary embolization has to be envisaged. Further experience with this method is necessary in order to compare the results with those obtained after bilateral surgical nephrectomy. Medical treatment with agents toxic to the tubules, in cases of the nephrotic syndrome, has apparently not produced the results expected. The relative simplicity of this embolization procedure has to be underlined, together with the fact that it is free from major complications when performed by surgeons trained in its use, on the condition that purification be carried out immediately following embolization.
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PMID:[Bilateral nephrectomy by embolization of the renal arteries: a report on five cases (author's transl)]. 624 96

The prospect of successful gestational outcome in pregnancies complicated by chronic renal insufficiency, severe hypertension, and diabetic vasculopathy is generally considered poor. This article describes a pregnancy with these complications in which a conservative form of management was utilized and resulted in a successful gestational outcome.
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PMID:Chronic renal failure and severe diabetic vasculopathy in pregnancy. 639 22

Administration of diuretics during acute renal failure in animals has been demonstrated to be of value with mannitol and/or loop-blocking diuretics, furosemide or ethacrynic acid. There is evidence that if these drugs are given very early in the controlled experimental environment that there will be some beneficial effect in maintaining renal function. However, in man the temporal relationship between the acute onset and the successful response to the administration of the drugs is, at best, coincidental and the use of diuretics in acute renal failure may not produce the same results as seen in the laboratory. One of the best guides to the underlying disease when there is acute decompensation in renal function is the utility of the renal failure index which utilizes urine and plasma sodium and urine and plasma creatinine ratios. Large doses of loop-blocking diuretics can be of benefit in patients with mild to moderate chronic renal insufficiency and fluid retention and/or hypertension. When renal insufficiency is severe in the pre-dialysis setting, furosemide, bumetanide or muzolimine may be of some benefit; however, as renal failure worsens the response of the kidney is sluggish and it is wise to begin to dialyze when glomerular filtration deteriorates below 5 ml per minute.
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PMID:The use of diuretics in varying degrees of renal impairment: an overview. 640 64

Eighty-two patients, 56 male and 26 female, biopsied since 1972 had IgA nephropathy. At the time of kidney biopsy, 24 patients were children and 58 were adults. In both groups the clinical course was documented in sufficient detail to allow prediction of disease outcome. Twenty-six (45%) of the adult patients had chronic renal insufficiency either at first evaluation or subsequently. Fourteen eventually required chronic hemodialysis. Hypertension as the initial sign of disease was seen more frequently in patients with chronic renal insufficiency. Adult males were more likely to have chronic renal insufficiency. The life table method was used to predict age at initiation of dialysis and kidney survival from date of onset of clinically apparent disease. Thirty-five percent of the male patients were predicted to require dialysis by age 40. Kidney death was predicted at 10 years from onset for 33% of male and 22% of all patients biopsied as adults. While all patients with progressive disease had over 2.0 g/24 h urinary protein excretion at least once, many individuals with serum creatinine concentration below 1.5 mg/dL showed marked fluctuation in degree of proteinuria, often exceeding 2.0 g/24 h. Thus, in some cases, degree of proteinuria was not a reliable predictor of outcome.
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PMID:Iga nephropathy: presentation, clinical course, and prognosis in children and adults. 647 50

A patient is described, admitted to the clinic on the occasion of proteinuria, edemas and arterial hypertension. The clinical and paraclinical data formed the picture of a renal involvement of mainly glomerular type with proteinuria to 5 gr%0, nonselective type, edemas, hypertension and data of chronic renal insufficiency I degree (serum creatinine to 3.8%, blood urea to 112 mg%). What impresses are the extrarenal manifestations as paresthesia of the lower limbs, with a sense of numbness to acute burning pain, a rich psychonervous symptomatics. The skin efflorescence, followed up and observed at the clinic of dermatology and the puncture biopsy material from the kidney revealed specific signs of Fabry syndrome.
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PMID:[Case of Fabry's disease]. 681 15

The course of treatment is demonstrated in 72 patients with chronic renal insufficiency who were undergoing regular hemofiltration for more than 6 months. 29 patients were treated for more than 5 years and 8 for more than 6 years with hemofiltration exclusively, total experience comprising 2,985 patient months. Thus, 16% of all patients accepted for artificial kidney treatment were selected for this form of therapy. Main reasons for transfer from hemodialysis to hemofiltration were hypotension, hypertension and/or repeated episodes of overhydration. In 12 patients with severe drug- and dialysis-resistant hypertension, blood pressure was normalized within 6 weeks after transfer to hemofiltration. Whereas some parameters of lipid and bone metabolism showed a tendency towards normalization, a favourable effect of hemofiltration on neuropathy was not observed. Main causes of death were encephalomalacia and cardiac infarction. Contraindications for post-dilution hemofiltration are vascular access problems resulting in a reduced blood flow and severe catabolism with accumulation of low molecular protein metabolites or potassium.
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PMID:Long-term follow up in chronic hemofiltration. 687 23

The values of PGf2 alpha were studied in 20 renal patients with renal hypertension, with and without chronic renal insufficiency via a radioimmunologic method. A control group of 10 healthy volunteers wer used without data from arterial hypertension. Values (672.0 +/- 99.5 pg/ml), being, with statistically significant difference, increased as compared with the healthy volunteers (347.13 +/- 49.9 pg/ml) were found in renal patients with chronic renal insufficiency. With the advancement of CRI in patients with renal hypertension, PG concentration was also increased (505.5 +/- 77.6 pg/ml) but it was not significant as in the patients without CRI. The elevated values of PGF2+ alpha suggest their participation in the pathogenesis of renal hypertension.
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PMID:[Prostaglandin F2 alpha and renal hypertension]. 695 May 90


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