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

Arterial hypertension is a frequent finding, even early in the course of diabetic nephropathy. Systemic and glomerular hypertension enhance the development of diabetic glomerulopathy and accelerate the rate of decline in glomerular filtration rate in diabetic nephropathy. Conversely, effective antihypertensive treatment reduces albuminuria and diminishes the rate of decline in glomerular filtration rate, thereby postponing end-stage renal failure in diabetic nephropathy.
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PMID:High blood pressure is a major factor in progression of diabetic nephropathy. 297 Oct 78

We report on 10 children, less than 2 years of age, who presented with a genuine type of glomerulopathy: diffuse mesangial sclerosis. In 5, the nephropathy was associated with male pseudohermaphroditism (MPH) and Wilms' tumor (WT); in 3 with MPH and in 2 with WT. The nephropathy was characterized by its very early onset, between the age of 2 weeks and 18 months. Eight patients presented with a nephrotic syndrome with (7 cases) or without (1 case) hypertension. All, but one, who is in advanced RF at 11 years of age, progressed to chronic or end-stage renal failure (ESRF) within a few months to 2 years from the onset. One additional child presented with advanced renal failure at the age of 8 months and the last one, who was hypertensive, developed an anuria related to thrombosis of renal veins at 1 year of age. Drash syndrome is characterized by the association of a "nephron disorder" with MPH and WT. We propose, on the basis of our histological findings, to extend the concept of Drash syndrome to patients who, in addition to the nephropathy, have either WT or MPH and to consider the distinctive glomerular lesions presented by all these patients as their common denominator. The pathogenesis of this glomerulopathy is obscure. Its early onset, its association with a dysembryoplastic tumor and/or with gonadal dysgenesis both suggest an antenatal dysgenetic process.
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PMID:The nephropathy associated with male pseudohermaphroditism and Wilms' tumor (Drash syndrome): a distinctive glomerular lesion--report of 10 cases. 300 Jun 66

Two groups of adult male Munich-Wistar rats and a third group of nondiabetic age-matched and weight-matched normal control rats underwent micropuncture study 1 mo, and morphologic studies 14 mo, after induction of streptozotocin diabetes or sham treatment. All animals were fed standard rat chow. Diabetic rats received daily ultralente insulin to maintain stable moderate hyperglycemia (approximately 350 mg/dl). In addition, one group of diabetic rats was treated with the angiotensin I converting enzyme inhibitor, enalapril, 15 mg/liter of drinking water. Average kidney weight, whole kidney and single-nephron glomerular filtration rate, and glomerular plasma flow rate were elevated to similar values in both groups of diabetic rats, relative to normal control rats. Non-enalapril-treated diabetic rats exhibited significant elevations in mean glomerular capillary hydraulic pressure and transcapillary hydraulic pressure gradient, compared with the other groups studied, and only this group eventually developed marked and progressive albuminuria. Likewise, histological examination of the kidneys at 14 mo disclosed a high incidence of glomerular structural abnormalities only in non-enalapril-treated diabetic rats. These findings indicate that prevention of glomerular capillary hypertension in rats with diabetes mellitus effectively protects against the subsequent development of glomerular structural injury and proteinuria. This protection is afforded despite pronounced hyperglycemia and elevated levels of glucosylated hemoglobin, further supporting our view that hemodynamic rather than metabolic factors predominate in the pathogenesis of diabetic glomerulopathy.
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PMID:Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. 301 62

A primary role for the kidney in the initiation and maintenance of hypertension has long been recognized, but the pathogenetic interactions among renal hemodynamics, hormonal and hereditary factors, and dietary sodium intake remain enigmatic. Reduction in filtration surface area, whether acquired in the course of intrinsic renal disease or after surgical renal ablation, leads to systemic hypertension as well as to progressive renal insufficiency, sequellae made even more severe by dietary sodium excess. Moreover, hypertension and progressive renal disease eventuate in some individuals born with a solitary kidney, as well as in those with more severe degrees of dysgenesis (ie, oligomeganephronia). Hypertension is also commonly observed in certain inbred rat strains in which filtration surface area is congenitally deficient. Based on these and other lines of evidence reviewed herein, we postulate that a renal abnormality that contributes to essential hypertension in the general population is a reduced number of nephrons. The consequences of this abnormality are limitations in the ability to excrete sodium and thus, salt-sensitive hypertension. Finally, congenital variability in filtration surface area may explain why only some, but not all, patients exposed to potentially injurious renal stimuli eventually manifest chronic nephropathy. This may also account for the susceptibility of subsets of Type I and Type II diabetics to develop overt glomerulopathy.
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PMID:Glomeruli and blood pressure. Less of one, more the other? 1691 17

Our study is an attempt to determine whether, after a vasculo-renal accident (VRA) in pregnancy, renal biopsy (RB) is of interest to determining the outcome specially of blood pressure. Starting from the 201 RB we systematically performed in such patients we may conclude: first, the onset of clinical and biological troubles do not allow to postulate the existing kidney lesions. Minimal changes observed in 31 women appeared early 9 times and during the last trimester 22 times. Most of the cases observed were preeclampsia (n = 108). The clinical or biological troubles were observed 44 times within the first months of the pregnancy and in 64 patients at the end of it. A specific group isolated concerns predominant vascular lesions (n = 44). Forward troubles were observed 16 times and 28 times during the third trimester. Second: a follow up has been possible for 1 to 5 years in 145 patients. A permanent hypertension occurred out of the 80 preeclamptic women, meanwhile among the 40 women with predominant vascular lesions, 60 p. 100 developed a permanent hypertension. Thus RB provides interesting data on renal lesions revealing sometimes (n = 18) a specific nephropathy (most of them were a glomerulopathy). Furthermore predominant vascular lesions suggest hypertension to recur in later pregnancy or become permanent.
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PMID:[Vasculorenal accidents in pregnancy. Prognostic value of renal biopsy]. 311 97

We describe 40 adults with idiopathic minimal-change glomerulopathy. They consisted of 27 females and 13 males, mean age 40.7 +/- (SD) 19.8 years (range 15-78 years). Twenty patients were less than 40 years of age at presentation. They presented with significantly (p less than 0.05) lower serum creatinine (0.9 +/- 0.2 vs. 1.3 +/- 0.5 mg/dl) and serum albumin (1.9 +/- 0.8 vs. 2.4 +/- 0.7 g/dl) levels than patients greater than 40 years. Only 7 patients (18%) presented with a decrease in renal function (serum creatinine greater than 1.3 mg/dl). All patients had nephrotic-range proteinuria at the time of presentation or biopsy. There was no significant difference in presenting proteinuria (8.7 +/- 5.7 g/24 h) or length of follow-up (mean 63.5, range 4-176 months) between the two age groups. Microscopic hematuria and hypertension were each present in 21% of the patients. Thirty-four patients received therapy with prednisone. A complete remission was obtained in 91% of the patients treated with prednisone. The response occurred within 16 weeks in 77% of the patients. The response to prednisone therapy was similar for patients less than 40 years when compared to those greater than 40 years, with a complete remission being obtained in 88 and 94%, respectively. The rate of response, however, differed significantly with 73% of patients less than 40 years versus 32% of patients greater than 40 years achieving a complete remission by 8 weeks. Twenty patients initially responding to prednisone therapy (64.5%) relapsed. A relapse occurred within 3 months of attaining a complete remission in 70% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Minimal-change glomerulopathy of adulthood. 318 23

Three hundred and twenty outpatients with diabetes mellitus (DM) were studied to evaluate the prevalence, origin (glomerular or nonglomerular), significance and possible association of glomerular hematuria (GH) with other clinical and laboratory features. In patients with 24 h proteinuria equal or superior to 500 mg, hematuria was seen in 16 out of 22 (72.7%); for those with 24 h proteinuria between 150 and 500 mg 5 out of 23 (21.7%) had hematuria, and in the general population of diabetics studied hematuria was present in 47 patients (14.7%). It was glomerular in 43 (13.4%) patients and nonglomerular in 4 (1.3%). Red blood cell casts were observed in 15 (34.9%) out of the 43 patients with GH. Ten out of 31 patients (32.3%) with GH, for whom 24 h proteinuria was available, had negative proteinuria in a 24 h urine when analyzed by routine methods. In 18 patients with GH, clinical and laboratory findings that could suggest a second form of glomerulopathy--nondiabetic--were negative. Renal biopsy in 9 of them showed only diabetic glomerulosclerosis. We have observed a significant association between GH and the male sex (p less than 0.001), high serum creatinine levels (p = 0.0002) and 24 h proteinuria greater than 150 mg (p less than 0.001). GH was more frequent among males with DM lasting more than 10 years (p less than 0.001) and among those with retinopathy (p less than 0.001). There was no association between GH and age, type of DM, insulin requirement or hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Glomerular hematuria in diabetics. 326 36

Post-transplant polycythemia is not uncommon in adult patients and is usually transient, responding to phlebotomy. Five pediatric patients developed erythrocytosis post-transplantation. Three patients had end-stage renal disease due to cystinosis, one had reflux glomerulopathy and one had focal glomerular sclerosis. The probable causes of the polycythemia were graft arterial stenosis in three patients. In one, polycythemia occurred with nephrosis. Polycythemia with hypertension may indicate the presence of arterial stenosis in children post-transplantation.
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PMID:Polycythemia in pediatric renal transplantation. 329 38

Immunotactoid glomerulopathy is a recently described entity characterized clinically by proteinuria, hematuria and hypertension, and on renal biopsy by various glomerular lesions including extracellular microtubules composed of immune reactants. Furthermore a defined immunological disease or cryoglobulinemia are absent. We report the case of a patient with immunotactoid glomerulopathy and hypocomplementemia (low C3 level) who developed several episodes of leucocytoclastic skin vasculitis with large immune deposits in and around small vessels. It is suggested that skin and renal involvement are part of the same systemic disease.
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PMID:Immunotactoid glomerulopathy with leucocytoclastic skin vasculitis and hypocomplementemia: a case report. 355 44

Administration of heparin to rats with 1 3/4 nephrectomy prevents the development of glomerulosclerosis, hypertension and retards the decrease in renal function seen in these rats. To further define the role of hypertension and/or coagulation in the pathogenesis of the glomerulopathy seen in this model we studied several groups of rats with 1 3/4 nephrectomy: (1) a control group; (2) a group receiving a 'high dose' of acetylsalicylic acid (50 mg/kg) plus dipyridamole (10 mg/kg); (3) a group receiving a 'low' dose (5 mg/kg body weight) of acetylsalicylic acid alone; (4) a group receiving OKY 1581, an inhibitor of thromboxane synthesis; (5) a group treated with antihypertensive medications; (6) a group receiving heparin subcutaneously twice daily, and (7) a group given oral Coumadin. Drugs in all groups were administered daily for 4 weeks. All treated groups had a decrease in blood pressure (BP), in the ratio of heart weight to body weight, in BUN levels and had fewer abnormal glomeruli. The effects of acetylsalicylic acid alone, of acetylsalicylic acid plus dipyridamole, and OKY 1581 may be due to inhibition of platelet aggregation and intraglomerular thrombosis, with the fall in BP being the consequence of improved renal function. On the other hand, the decrease in BP may be related to a primary effect of these drugs. The lower BP in turn may play a role in slowing the progression of renal disease and improving the renal histology in the treated groups.
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PMID:Role of hypertension and coagulation in the progressive glomerulopathy of rats with subtotal renal ablation. 369 94


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