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

A significant number of offspring from brother-sister matings of NIH-Okamoto-Aoki spontaneously hypertensive rats (SHRs) were found to be normotensive at 20 weeks of age. Over 20% of the animals that were hypertensive at this age had mild-to-moderate unilateral hydronephrosis at the time of sacrifice. In over 90% of the rats that did not develop hypertension spontaneously, ligation of one ureter raised blood pressure above 150 mm Hg within 2 weeks. In those rats made hypertensive by obstructing one ureter and in those that developed hypertension with accompanying naturally occurring hydronephrosis, subcutaneous implants of fragmented renal medulla from unrelated normal rats decreased blood pressure to normotensive levels. In contrast, medullary implants had no significant effect in rats developing hypertension spontaneously without hydronephrosis. Renal inner medullary plasma flow was low in the obstructed kidneys of hydronephrotic hypertensive SHRs but was elevated in the kidneys of nonhydronephrotic hypertensive SHRs. The hypertension in hydronephrotic SHRs appears to be related to an impairment of the antihypertensive function of the renal medulla. Such an impairment of medullary antihypertensive function does not appear to play a significant role in the hypertension in SHRs without hydronephrosis.
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PMID:The renal medulla and mechanisms of hypertension in the spontaneously hypertensive rat. 99 30

Ex vivo renal artery reconstruction and autotransplantation is a relatively recent addition to the surgical armamentarium for renal vascular hypertension. Ten consecutive patients were considered for this surgical therapy and form the basis of this communication. The patients were treated by a combination of methods including bilateral ex vivo reconstruction, unilateral in situ and contralateral ex vivo reconstruction, and unilateral ex vivo reconstruction and contralateral nephrectomy. Replacement of the diseased segment of the renal artery in all ex vivo reconstruction consisted of arterial autografts including hypogastric artery, splenic artery, common iliac, and external iliac artery. In the ex vivo reconstruction, the ureter was either left intact or was transected and reconstructed by standard ureterovesicle implantation. After surgery all patients became normotensive without antihypertensive medication. Although this is a relatively small series, the uniform good results in these patients with extensive disease suggest that ex vivo renal artery reconstruction is a safe and effective method of treatment. Thus, it should be more widely applicable, expecially in those patients with renal vascular disease who were previously thought to be inoperable or eligible for nephrectomy only.
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PMID:Ex vivo renal artery reconstruction. 118 May 83

Renal artery aneurysms were diagnosed in 11 patients (9 boys) aged 1 to 14. The examinations were carried out for vasorenal hypertension in 4 cases, for bladder-ureter reflux, hematuria, nephroptosis in 4, ureterohydronephrosis in 2 cases, and for interstitial nephritis. Aneurysms of the major trunk of the renal artery, mostly oval-shaped, 11 x 14 to 25 x 28 mm in size, were detected in 4 patients, intrarenal aneurysms 2 x 3 to 5 x 6 mm in size in 7 cases. The share of aneurysms among uronephrologic conditions in children was found to be 1.54%, among vasorenal hypertension cases, 4.3%. Vasorenal hypertension is the main optional sign of aneurysms of the main trunk of the renal artery, whereas for intrarenal aneurysms such sign is hematuria.
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PMID:[Renal artery aneurysms in children]. 130 2

A partial obstruction of the left ureter was created in weanling (3-week-old) rats. Renal function was studied after 7-9 weeks and compared to that in age-matched controls. Arterial blood pressure was found substantially increased. During normal hydration, the hydronephrotic kidney had low excretions of urine, potassium, osmoles and, especially, sodium. The contralateral, intact side showed no compensatory traits. On volume expansion, the hydronephrotic kidney demonstrated an unimpaired reacting capacity, leading to normalization of urine, sodium and osmole excretions and even to supernormal renal blood flow, glomerular filtration and potassium excretion. On the intact side, the excretion of potassium was increased like that on the hydronephrotic one, while excretions of urine, sodium and osmoles were increased even more. The fact that the intact kidney handled most of the urine excretion was interpreted as the result of a mechanism protecting the obstructed kidney from additional pressure insults while homeostasis was maintained. The arterial hypertension may result from the combination of retention of fluid and sodium by the hydronephrotic kidney and the absence of compensation by the intact kidney during normal hydration--like that in everyday life. The functional changes during normal hydration were generally more severe than those we found after obstruction in neonatal and adult rats, in which arterial hypertension was never observed. The clinical implication would be that the kidney may be less tolerant to pressure rises during the infant year. Changes due to obstruction are known to occur rapidly, but after that neither progress nor reverse.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Partial ureteric obstruction in weanling rats. II. Long-term effects on renal function and arterial blood pressure. 141 99

Renal and ureteral calculi are treated primarily using extracorporeal lithotripsy, with percutaneous nephrostolithotomy retaining an important role for the treatment of large stones and complex situations. Aspects of pretherapy evaluation are reviewed. The vast majority of calculi 5 mm or less in diameter in the mid and lower ureter will pass spontaneously; in patients with acute ureteral obstruction, lower-osmolar nonionic contrast for urography caused as much discomfort as conventional high-osmolar contrast. Treatment planning for extracorporeal lithotripsy has changed in that internal stenting is no longer routinely recommended. Milk-of-calcium and calyceal diverticular stones respond poorly to extracorporeal lithotripsy. The access route used for percutaneous stone removal varies among investigators. Some advocate an intercostal approach for up to one third of patients; substantial complications occur with placement of a track above the 11th rib. Sepsis develops after percutaneous nephrostomy in up to 21% of patients, but the risk of sepsis can be decreased significantly by the administration of antibiotics during and after the procedure. Complications of extracorporeal lithotripsy include renal hematoma (especially if the patient is hypertensive or is taking aspirin), regional organ injury, and bacteremia. Although originally feared to occur frequently, hypertension occurring after or caused by extracorporeal lithotripsy was not confirmed to be a major problem. The incidence in a 2-year postlithotripsy follow-up was no greater than that for control subjects.
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PMID:Radiology and treatment of urinary tract stone disease. 155 85

Brown Norway kininogen-deficient rats had very low levels of plasma kininogens and lower levels of plasma prekallikrein, compared with those of normal rats of the same strain. Systolic blood pressure, determined by the tail-cuff method, of 5-week-old kininogen-deficient rats (106 +/- 0.4 mm Hg, n = 7) and the rate of systolic blood pressure increase with age were not different from those in normal rats. Weekly injections of deoxycorticosterone acetate (5 mg/kg s.c.) with 1% sodium chloride solution in drinking water after uninephrectomy at 7 weeks of age caused a gradual increase in the blood pressure of normal rats, reaching a plateau at 18 weeks of age, whereas that of deficient rats rose rapidly to 158 +/- 6 mm Hg 2 weeks after the start of treatment and continued to increase slightly, becoming significantly higher than normal rats at 8, 9, 10, 11, and 12 weeks of age (p less than 0.05 or 0.01). The levels of urinary prokallikrein and active kallikrein were slightly higher in deficient rats before deoxycorticosterone acetate-salt treatment but were not significantly increased after this treatment, whereas these levels in normal rats were increased 3.6- and 4.7-fold by this treatment. Urinary free kinin, collected from the ureter in untreated deficient rats, was below the detection limit. The plasma level of low molecular weight kininogen, the substrate of glandular kallikrein, was decreased in normal rats during the treatment. Continuous subcutaneous injection of aprotinin by an osmotic pump to normal rats induced significant increase in blood pressure. These results indicate that glandular kallikrein may play a suppressive role in deoxycorticosterone acetate-salt hypertension.
Hypertension 1991 Jun
PMID:Suppression of rat deoxycorticosterone-salt hypertension by kallikrein-kinin system. 171 Jun 5

Cystic kidney dysplasias (multicystic kidney disease) are differentiated from hyperplastic and ectatic cystic kidney diseases by means of pathogenesis in order to simplify the common classification. Six cases of cystic kidney dysplasia are reported (1 child and 5 adults) and in a review of the literature diagnostic and therapeutic strategies are discussed. A characteristic radiological sign is the clublike++ deformation of the rudimentary ureter. Nephrectomy is indicated in case of symptoms such as pain, hypertension or recurrent urinary tract infections or in case of atypical cysts with a risk of malignancy.
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PMID:[Differential diagnosis of cystic kidney dysplasias]. 182 34

During a 2-year period, 884 extracorporeal piezoelectric lithotripsy treatments have been performed on stones in 388 renal units (kidney and upper ureter) using a Wolf Piezolith device.* Lithotripsy routinely was performed on an outpatient basis without use of anesthesia or premedication. Often, the maximum number of pulses allowable by a Food and Drug Administration protocol (4,000) was delivered and retreatments frequently occurred on successive days. Of the patients 75% were stone-free 3 months after treatment, while another 20% had only residual small fragments. No intrarenal or perinephric hematomas were observed and only 1 patient has had hypertension requiring medication. Renal colic from passage of stone fragments occurred in only 10% of the patients. An aggressive treatment policy using repeat treatments as necessary provides for superior results with this device without an incision or complication.
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PMID:A 2-year experience with the Wolf piezoelectric lithotripter: impact of repeat treatment on results and complications. 203 81

A 23 year old female, born in 1957, was diagnosed as having idiopathic thrombocytopenic purpura at the age of 3 and treated with prednisolone during her childhood with no response. On her regular check-up in 1978, facial edema and proteinuria suggested renal disease. The family history was negative for bleeding diathesis or renal disease. Close examination revealed the following: WBC 4,200/microliters without leukocyte inclusions, RBC 3.42 x 10(6)/microliters, Hb 11.7 g/dl. PT 10.6 sec, APTT 28.9 sec. Platelet count 4,500/microliters by HEMATRAK 360, and 40 x 10(3)/microliters measured by microscopic method. Giant platelets were noted on peripheral blood smear with an average diameter of 6.1 microns. Bleeding time (Duke) was 12.0 min. Number of megakaryocytes was increased although platelet production was remarkably decreased. Results of platelet aggregation and retention tests were normal. Platelet life span (T1/2) was 2.3 days. Sensory neural hearing loss, congenital cataract, double ureter and short small intestine were also found. Chromosome analysis showed 46XX. She underwent splenectomy resulting in increase of the platelet count to 226 x 10(3)/microliters. The increased platelet count, however, gradually decreased to the initial count in 2 years although the bleeding tendency was improved. In 1987, renal function deteriorated, causing intractable hypertension. The serum creatinine was 4.8 mg/dl. The following year she developed cerebral bleeding and died 4 days after the episode. The serum creatinine was 8.6 mg/dl.
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PMID:[Macrothrombocytopenia with deafness, nephritis, cataract, short small intestine, and double ureter]. 221 83

Ultrasonography and intravenous pyelography (IVP) were compared for their diagnostic value in 65 patients (29 women, 36 men; mean age 57 [19-85] years) thought to have disease of the kidneys or urinary tract (microhaematuria in 16, macrohaematuria in 5, urinary tract infection in 11, suspicion of renovascular hypertension in 6, suspected tumour in 5, suspected nephrolithiasis in 15, and flank pain of uncertain cause in 7). Ultrasound established an abnormal condition in 29, in five of which IVP gave false positive results, false-negative results in three. The false-negative results were an indirect sign of renal artery stenosis in one patient and in one patient each of duplex ureter and cystic ureteritis. Mild hydronephrosis (n = 3), stone in a kidney or the renal calyx system (n = 2) and tumour of the right kidney (n = 1), diagnosed by ultrasound, were not seen by IVP. Concordant results were thus obtained in 70% of cases. Ultrasound examination of the urinary tract gives such reliable results that in many cases an additional IVP is unnecessary.
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PMID:[A comparison of sonography and intravenous pyelography in diseases of the kidneys and urinary organs]. 240 30


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