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

Previous studies in a population of 721 children aged 2--14 years demonstrated the familial aggregation of blood pressure in children, and a significant regression coefficient (b = 0.25) of follow-up on initial blood pressures over a four-year period. Urinary kallikrein concentration (UKal) also aggregated in families, was lower in black than in white children and was inversely related to blood pressure. Further studies in the same cohort have been conducted. These variables were again measured in 484 children in 129 families seven to eight years after the initial blood pressure and three to four years after the original UKal measurements were made. Familial aggregation again was found for blood pressure and urinary kallikrein. Blood pressure tracking was demonstrated by the finding that blood pressure scores at the third survey were related significantly to those at both previous surveys. Kallikrein concentrations in casual urines at Survey 3 were related to those obtained at Survey 2 (r = 0.499), and were again significantly lower in black than in white children (log = 3.84 +/- 0.8 vs 4.37 +/- 0.7; P less than 0.001). These were significant inverse relations between UKal/creatinine concentration and blood pressure in both white and black children. Thus, familial aggregation of blood pressure, blood pressure rank and concentration of kallikrein in casual urine specimes are relatively stable in children over an eight-year period of observation. This study demonstrates in a free living population of normal children, a stable relation between blood pressure and an enzyme which is involved in the production of potent vasodilator peptides and is related to hypertension in adults.
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PMID:Stability of blood pressure rank and urinary kallikrein concentration in childhood: an eight-year follow-up. 69 59

Eleven patients with hypertension secondary to renal disease were treated with hydrochlorothiazide or furosemide plus other drugs to normalize blood pressure. Creatinine clearance fell during the initial treatment period, but then either remained constant or rose toward pretreatment levels in spite of continued therapy. Plasma renin activity was low-normal to subnormal in eight of the 11 patients prior to therapy and did not rise significantly with therapy. Aldosterone excretion was within the normal range prior to treatment and remained normal or increased moderately with treatment. This study demonstrates that diuretics effectively reduce blood pressure in patients with hypertension secondary to renal disease without producing severe volume depletion or clinically significant reduction in renal function. The low renin levels are consistent with other evidence that hypertension in these patients is related to salt and water retention.
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PMID:Use of diuretics in treatment of hypertension secondary to renal disease. 70 75

Percutaneous transluminal dilatation was performed in 5 patients with unilateral atherosclerotic renovascular disease and one patient with occlusion of a renal artery. Hemodynamic activity of the stenosis was documented by determination of pre- and poststenotic blood pressure values and by measurement of renal plasma flow. Flowing transluminal dilatation all patients showed a significant drop in blood pressure and antihypertensive treatment could be reduced or even discontinued. Only one patient became hypertensive again 3 months after the dilatation procedure. In this patient both the reduction of renal plasma flow and the delayed nephrographic effect on the stenotic side in the intravenous urogram were interpreted as symptoms of a recurrence of significant renal artery stenosis. In 2 of the six patients with impaired kidney function glomerula filtration are increased, as documented by a decrease in serum creatinine values. The results show that percutaneous transluminal dilatation may be a valuable method in the management of renovascular hypertension.
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PMID:[Renovascular hypertension: therapy by means of percutaneous transluminal dilatation of renal artery stenoses]. 71 24

Seventeen children, 12 boys and 5 girls with histopathologic confirmation of focal sclerosing glomerulonephritis (FSG) presented with nephrosis (100%), hypertension (64.7%), intermittent hematuria (58.8%) and associated infection (82.3%). The coagulation-profile study in these patients revealed a hypercoagulable state characterized by significant elevation of fibrinogen and factor V concentrations and platelet count (P less than .002--.02). Increased blood viscosity (13.64 +/- 3.3 cp) was also noted in the patients (controls 10.8 +/- 0.9 cp). Determination of platelet half-life and fibrinogen half-life demonstrated that these were both shortened (P less than .001). Predominant shortening of platelet half-life was observed in 3 of the 4 patients during heparin therapy but this reverted to normal during therapy with the antiplatelet agent (Persantin). These findings signify the presence of a low-grade intravascular coagulation which perhaps occurs in the glomerular capillaries. Significant increments in creatinine clearance (CCr) and renal blood flow (RBF) were observed with treatment in the 9 anticoagulant-treated patients but not in the 8 control patients treated with prednisone and cyclophosphamide.
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PMID:Focal sclerosing glomerulonephritis: a kinetic evaluation of hemostasis and the effect of anticoagulant therapy: a controlled study. 72 13

In 25 patients receiving sodium nitroprusside (SNP) infusion for hypertension, the influence of SNP on renal function, thiocyanate (SCN) concentration, half-life of SCN and hemolytic actions or methemoglobinemia was measured. Creatinine clearance showed a slight increase while plasma creatinine was unchanged. There was no definite relationship between creatinine clearance and SCN clearance. For the individual patient there was no relationship between the SCN concentration at a constant dose of SNP and the degree of renal function. Independently of the grade of renal insufficiency, toxic concentrations of SCN were never seen if less than 100 gamma/min/SNP were infused for less than 5 days ( = less than 720 mg total dose). There was a linear relationship between half-life of SCN and the degree of renal function. Signs of hemolytic action could not be demonstrated. There was no methemoglobinemia. Although SCN concentration in relation to dose of SNP and renal function cannot be predicted, it is proposed that plasma SCN be checked only in patients receiving more than 100 gamma/min for more than 5 days.
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PMID:[Toxicity and blood concentration of thiocyanate during sodium nitroprusside treatment]. 74 97

The effect of renal vascularization on renal function in kidneys with poor preoperative excretory function is summarized in this report. Twenty-five patients with kidneys having preoperative creatinine clearance of less than 30 ml/min, as determined during split renal function studies (SRFS), which were revascularized for treatment of secondary renovascular hypertension and then were reevaluated by repeat SRFS form the basis of this report. There were 13 male and 12 female patients. The type of renal artery lesion was atherosclerotic in 21 patients and fibromuscular dysplastic in four patients. Eight individuals had total renal artery occlusion. Significant contralateral renal artery disease was present in 15 patients (60%). Preoperative creatinine clearances in the affected kidneys ranged from 0.27 ml/min (mean, 16 +/- 9 ml/min). after operation, creatinine clearances ranged from 0 to 72 ml/min (mean, 32 +/- 16 ml/mn). Fifteen of the 16 kidneys with preoperative creatinine clearances less than 20 ml/min had improvement in renal function following revascularization (P less than 0.01). Improvement (60%) or cure (36%) in hypertension followed revascularization in 24 of the 25 patients. The most dependable predictor of successful management of both hypertension and retrieval of renal function in these patients was the arteriographic demonstration of a patent distal vessel without evidence of severe intrarenal stenoses. These results support an aggressive attitude toward the use of revascularization in the operative treatment of such patients with renovascular hypertension, even when the residual excretory function is minimal or absent.
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PMID:Revascularization of the poorly functioning kidney. 75 14

In 10 healthy and 27 diabetic children aged 11--17 years plasma renin activity was determined in horizontal position (PRA-I) and after stimulation by furosemid and upright position (PRA-II). In diabetic children with or without hypertension and protein-uria, and a normal or only slightly elevated plasma creatinine level normal PRA-I and PRA-II values were found.
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PMID:[Plasma renin activity in diabetic children (author's transl)]. 76 47

1. Patients with cadaveric renal transplants and plasma creatinine less than 177 micronmol/l who had their own kidneys removed were studied. 2. The renin-angiotensin system appeared to behave in a normal fashion in response to alterations in sodium intake and posture. 3. The renin-angiotensin system had no major role in the establishment or maintenance of hypertension. 4. Mean arterial pressure was directly related to expansion of the extracellular fluid volume.
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PMID:Plasma renin activity, plasma angiotensin II and extracellular fluid volume in patients after renal transplantation. 79 52

In 53 patients, 24 healthy pregnant women and 29 patients with EPH (edema, proteinuria, hypertension) syndrome, the intravenous phenolsulphonphthalein test was performed between the 32nd and 42 weeks of pregnancy. At the same time, the serum creatinine and estrogen excretion in the 24 hour urine were determined. According to this, normal pregnancy and also pregnancies with one or more symptoms of the EPH syndrome without raised blood pressure do not cause changes of the PSP plasma level. A statistically significant rise in the PSP plasma level is only found with a blood pressure of 140/90 mm Hg, and simultaneously a close correlation to the estrogen excretion in the urine (r = -0.4) and the blood pressure (r = 0.6). Estrogen excretion is reduced with increasing blood pressure (r = -0.75). No correlation could be established between the PSP serum level and the creatinine in the serum.
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PMID:[Investigations of changes in the phenolsulphonphthalein plasma levels in pregnant women with EPH syndrome (author's transl)]. 80 10

The juxtaglomerular apparatus was histoplanimetrically studied in renal biopsies of 65 cases of membranoproliferative glomerulonephritis and 64 cases of minimal proliferative intercapillary glomerulonephritis (MPI) ("minimal changes"). The juxtaglomerular cell complex (JGC complex) consisting of the epithelioid cells (granular cells) and the Goormaghtigh's cells (agranular or lacis cells) was significantly enlarged in the nephrotic syndrome. 10 to 14 days' duration of the nephrotic syndrome was shown to be sufficient to bring about an enlargement of the JGC complex. After a successful treatment of the nephrotic syndrome with steroids, there was no enlargement of the JGC complex. The enlarged JGC complex persisted despite steroid treatment in the steroid-resistant nephrotic syndrome, although a mild suppressive effect of steroids on the size of the JGC complex was observed. There was no significant relationship between hypertension and the size of the JGC complex. Creatinine retention tended to be associated with an enlargement of the JGC complex. The macula densa was not enlarged in the nephrotic syndrome, in contrast to the enlarged JGC complex.
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PMID:The size of the juxtaglomerular apparatus in glomerulonephritis with the nephrotic syndrome: a morphometrical study of renal biopsies. 80 4


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