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 considered the hypothesis that CAPD is a superior treatment to HD in patients with dialysis-refractory hypertension. We compared 12 HD patients to 22 CAPD patients entered to our program over a one year period. All had been treated for hypertension before dialysis. We found that systolic blood pressure decreased in CAPD patients compared to HD patients, even though medications were more commonly reduced in CAPD patients compared to HD patients. Ten CAPD patients required no medications after one year's treatment. These preliminary data in this small pilot study support the notion that CAPD is superior to HD in blood pressure management of hypertensive patients. A large, multicenter study may be warranted to determine if CAPD favorably influences the risk of cardiovascular complications in dialysis patients compared to HD.
Adv Perit Dial 1989
PMID:Hypertension in dialysis patients: does CAPD provide an advantage? 257 37

A modified transluminal angioplasty technique for treatment of renal artery occlusion has been developed. From 1980 to 1985, 16 consecutive patients with 17 complete main renal artery occlusions underwent interventional transfemoral angiography for the purpose of recanalisation. In 12 patients the orifice of the renal artery could be clearly localised, so an attempt was made. Successful revascularisation of the occluded vessel was accomplished in seven patients. In four of these seven, contralateral renal artery stenosis was detected and dilated at the same session. Intact vasculature could be demonstrated distal to the occlusion. In six patients an improvement of renal function was apparent at the end of the dilatation procedure; this was indicated by the appearance of contrast material in the pelvicalyceal system. The mean serum creatinine fell from 4.6 +/- 2.9 to 1.9 +/- 0.4 mg/dl. Radioisotope studies confirmed improvement of renal function in the previously occluded kidney in four of four patients. Three patients had acute oliguric renal failure, which was reversible in two cases following revascularisation. Transluminal angioplasty improved hypertension in all cases. Mean blood pressure fell from 187/110 to 155/88 mmHg. Non-operative renal artery revascularisation can be achieved by transluminal angioplasty techniques and is an alternative to surgery in patients with increased operative risk.
Nephrol Dial Transplant 1988
PMID:Non-operative revascularisation of renal artery occlusion by transluminal angioplasty. 297 98

A total of 13 procedures of percutaneous transluminal angioplasty were performed in 11 kidney graft recipients with renal transplant artery stenosis. Nine procedures were technically successful in eight patients (one redilatation was necessary because of restenosis). Graft biopsy confirmed rejection nephropathy in all cases. The outcome could not be evaluated in one patient who died of a concomitant disease shortly after angioplasty. The remaining seven patients (eight percutaneous transluminal angioplasties) showed improvement in hypertension in 63% and in glomerular filtration rate in 50% of procedures, persisting for 6-13 months. A single major complication encountered was a loss of graft related to unsuccessful percutaneous transluminal angioplasty. The results suggest that percutaneous transluminal angioplasty may bring prolonged increase in effective renal plasma flow and glomerular filtration rate even in patients experiencing rejection nephropathy.
Nephrol Dial Transplant 1988
PMID:Percutaneous transluminal angioplasty of renal transplant artery stenosis in patients with rejection nephropathy. 297

To study the effectiveness and nephrotoxic side-effects of cyclosporin A (CsA) in renal transplant recipients, a prospective randomised trial was designed to compare CsA with azathioprine (Aza). Each treatment group consisted of 40 patients; in the CsA group, 18 were randomly selected for conversion to Aza after 3 months. The 1-year graft survival for CsA-treated patients was 87% compared with 66% for the Aza group (P = 0.033). Anti-rejection therapy was administrated to 78% of the patients in the Aza group and 47% of those in the CsA group (P less than 0.01). There was no difference in the incidence of primary non-functioning kidneys, cytomegalovirus infections, hypertension, or degree of proteinuria between the two treatment groups. At 3 months the mean creatinine clearance was 42 +/- 2 ml/min (mean +/- SEM) for the CsA group compared with 56 +/- 4 ml/min for the Aza group (P less than 0.01), whereas the mean creatinine clearances at 6 months for both the converted and the non-converted CsA-treated patients did not differ from that found in the Aza-treated group. At 1 year, the mean creatinine clearance for CsA-treated patients who were converted to Aza was higher than that found for Aza-treated patients (62 +/- 7 vs 50 +/- 6 ml/min; P less than 0.05). Furthermore, the increment in creatinine clearance observed after conversion from CsA to Aza at 3 months showed a linear relationship (r = 0.9061) with the CsA trough levels before discontinuation of the drug. This indicates that CsA treatment induces a dose-dependent, nephrotoxic side-effect which is probably reversible.
Nephrol Dial Transplant 1986
PMID:A prospective randomised comparative study on the influence of cyclosporin and azathioprine on renal allograft survival and function. 311 Jun 62

The prevalence of hypertension was studied in renal transplant recipients followed for at least 1 year. Twenty-eight patients with a transplant renal artery stenosis, all with hypertension, were excluded from further study. Hypertension was present at 1 year after transplantation in 48.3% of 329 cadaveric renal graft recipients, treated with azathioprine. These hypertensive patients had experienced more rejection episodes. The prevalence of hypertension was higher in patients with (n = 237) than in those without (n = 92) host kidneys in situ (57.8% and 23.9% respectively, P less than 0.001). In patients with host kidney, the prevalence of hypertension was higher in patients with glomerulonephritis (n = 108) than in those in whom interstitial nephritis (n = 63) was the original renal disease (71.3% and 42.8 respectively, P less than 0.001). In 41 patients initially treated with cyclosporin and in 42 recipients of a kidney from a living donor, the prevalence of hypertension was not clearly lower than in the azathioprine-treated patients. In 30 patients without host-kidneys who did not experience acute rejections, only three had hypertension. In all three patients a specific cause for the hypertension was found. In hypertensive patients, blood pressure decreased gradually in the years following transplantation. In conclusion, besides transplant renal artery stenosis, the main determinants of the prevalence of hypertension after renal transplantation are host kidneys original renal disease, and rejection.
Nephrol Dial Transplant 1987
PMID:Factors determining the prevalence of hypertension after renal transplantation. 311 Jun 95

C3 and Bf alleles were examined in the general population, in 67 patients with biopsy-confirmed mesangial IgA nephropathy and 81 patients with other types of glomerulonephritis, from the Heidelberg and Leiden renal programmes respectively. In both populations, a significant excess of homozygous phenotype C3FF (3.4% in controls; 10.4% in IgA nephropathy) and a deficit of C3FS heterozygous phenotype (35.8% in controls; 19.4% in IgA nephropathy) were observed in patients with IgA nephropathy, but not in other types of glomerulonephritis. No difference of C3 gene frequencies was found. C3FF was associated with an adverse clinical outcome (a higher prevalence of renal failure and hypertension). A significant excess of Bf-F gene frequency was noted (0.20 in controls; 0.33 in IgA nephropathy). In addition, an excess of phenotype BfFF was found (none in controls; 10.4% in IgA nephropathy). BfFF homozygotes also carried a higher risk of an adverse outcome (renal failure and hypertension). The data suggest a role for genetically coded (presumably) immunological factors in the genesis and course of IgA nephropathy.
Nephrol Dial Transplant 1987
PMID:Genetic polymorphism of C3 and Bf in IgA nephropathy. 311 58

An expert system has been integrated to the data management system of the ARTEMIS programme for hypertensive patients. The patient database, which has been used since 1975, contains the medical records of about 20,000 patients. Information is interactively entered by physicians, nurses and secretaries on video display units. The computerised medical record has replaced the traditional handwritten medical record. The database management system is used to produce different summary reports (inpatient and outpatient care) and personalized recall letters which are mailed to the patients before their appointments. Suggestions provided by the expert system include additional information to be obtained (complementary patient interrogation, biological or radiological investigations, etc.), possible causes of hypertension, and medical prescriptions. The information base allows the description of both static knowledge (in the form of a semantic network) and dynamic knowledge (in the form of production rules). The inference system sequentially uses a combination of forward and backward chaining and performs both exact and approximate reasoning. The diagnostic performance of the expert system was evaluated in 100 cases of hypertension (50 of essential hypertension and 50 of secondary hypertension. Concordance between the diagnosis proposed by the expert system and the one proposed by the specialist was achieved in 92% of secondary hypertension cases and 88% of essential hypertension cases. It is suggested that the integration of data and knowledge management might enhance the overall acceptance by medical staff of a computerised system, and facilitate the validation of a knowledge base.
Nephrol Dial Transplant 1987
PMID:Integrating management and expertise in a computerised system for hypertensive patients. 312 10

In 51 consecutive patients with malignant hypertension collected from 1976 to 1981 we have analysed patient and kidney survival at 5 years and at last follow-up. The patients were 41 men, 10 women, mean age 53 years, with a stage III (63%) or stage IV (27%) fundi and a diastolic blood pressure (BP) greater than 130 mmHg. The hypertension was primary in 26, renovascular in 17 and secondary to bilateral nephropathy in eight. At 5-years follow-up, the patient and kidney survival rates were respectively 72.5% and 47%. At last follow-up, 18 patients had died (35%) and 18 additional patients require dialysis (renal death = 70%). The principal causes of death related to terminal renal failure and/or dialysis. Initial involvement of heart (27%) and brain (35%) led to a few more deaths. Blood pressure control reduced consequences for the heart and brain but not for the kidney. Patients at higher risk are those with serum creatinine greater than 200 mumol/l on admission.
Nephrol Dial Transplant 1988
PMID:Long-term prognosis in malignant or accelerated hypertension. 313 37

Blood pressure control and its influence on the rat remnant kidney function were studied. The deterioration in kidney function was followed for up to 20 weeks at 4-weekly intervals in four groups of 5/6th nephrectomised rats. The groups studied were: (1) Control, untreated (C), given normal rat chow containing 21% protein; (2) nisoldipine (a dihydropyridine calcium channel blocker) treated (N), given nisoldipine freshly mixed daily in normal chow (0.3-0.6 mg/kg body weight); (3) dihydralazine-treated (H), fed normal chow and given dihydralazine added daily to the drinking water, about 15-25 mg/kg body weight daily; and (4) low-protein (6%) diet (LP), isocaloric and having the same sodium content as the normal chow. Proteinuria, serum creatinine, blood urea, histological damage as seen by light microscopy, and cumulative survival were taken to assess the severity of the chronic renal failure. All three therapeutic regimens attenuated significantly the rise in blood pressure which developed within less than 4 weeks in the rats with the remnant kidney. At the 16th week, means +/- standard deviations were, in group C, 237 +/- 20 mmHg; group N, 147 +/- 20 mmHg; group H, 164 +/- 23 mmHg; and group LP 149 +/- 16. Systolic blood pressure at the 8th week had a significant correlation with the serum creatinine of the 12th and of the 16th weeks. There was a strong correlation between blood pressure and the serum creatinine at the 16th week. This indicates that a time lag is necessary for the hypertension to have an effect on kidney function. Proteinuria, serum creatinine and blood urea were much higher in the untreated group.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1988
PMID:The control of hypertension and its effect on renal function in rat remnant kidney. 313 38

A retrospective study of 67 patients with IgA nephropathy carried out at the Glasgow Royal Infirmary revealed an overall 10-year actuarial renal survival of 77.4%. At the time of presentation, 27 patients (40.3%) were hypertensive and 40 (59.7%) were normotensive. As expected, the survival was worse in the hypertensive group. However, when the effect of control of blood pressure was assessed, a significantly worse survival was found in those whose hypertension was inadequately controlled, compared to those whose hypertension was well controlled, in whom survival was not significantly different from that of the normotensive group. The differences in survival could not be explained by increased patient age nor by longer duration of disease. Good control of hypertension may prevent progression to end-stage renal failure in IgA nephropathy.
Nephrol Dial Transplant 1988
PMID:Progressive IgA nephropathy: the role of hypertension. 314 79


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