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

Aspirin has been shown to acutely block the natriuretic effect of spironolactone in the mineralocorticoid-treated normal rat, dog, and man. It has been suggested that aspirin is contraindicated in hypertensive patients receiving spironolactone. Five patients with low-renin essential hypertension and two with hypertension due to primary aldosteronism, all of whom have normalized their blood pressure on chronic spironolactone therapy, were cotreated in a double-blind fashion with either aspirin or aspirin-placebo during alternate six-week periods. Aspirin did not appear to alter the effect of spironolactone on blood pressure, serum electrolytes, urea nitrogen, or plasma renin activity.
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PMID:Failure of aspirin to antagonize the antihypertensive effect of spironolactone in low-renin hypertension. 78 8

The present studies were designed to characterize the extent and pathogenesis of the glomerular lesions which occur in the viable portion of the kidney following partial renal infarction in rats. Control rats with two normal kidneys had a mean blood pressure of 112 mm Hg, minimal proteinuria and no glomerular pathology on light (LM), electron (EM) or immunofluorescence microscopy (IFM). Rats with two-thirds infarction of one kidney (stage II) became hypertensive, although less than 4% of the glomeruli from either kidney were abnormal. Rats with two-thirds infarction of one kidney and contralateral nephrectomy (stage III) developed proteinuria and hypertension whether fed a normal, low or high Na+ diet. By light microscopy 37% of glomeruli were abnormal 28 days after partial infarction and contralateral nephrectomy and thereafter the percent of abnormal glomeruli increased. Detectable amounts of immunoglobulin and complement (C3) were present in kidneys of stage II or III rats but were always accompanied by more extensive albumin and fibrin deposits. Basement membrane deposits characteristic of immune complexes were not seen on EM. Administration of antihypertensive medication to stage III rats significantly lowered blood pressure and reduced the number of abnormal glomeruli on LM; however, IFM abnormalities remained prominent. Platelet thrombi seen by EM and abundant glomerular fibrin deposits seen on IFM suggested that coagulation mechanisms may be prominent in the pathogenesis of the renal lesion. Heparin-treated stage III rats had significantly lower blood urea nitrogen concentrations, blood pressures and proportion of abnormal glomeruli although glomerular deposition of serum proteins was still present on IFM. These observations suggest that this glomerulopathy is initiated by an unknown agent(s) which increased capillary permeability. This lesion progresses via thrombotic mechanisms which are prevented by heparin administration.
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PMID:Pathogenesis of the glomerulopathy associated with renal infarction in rats. 94 Feb 76

Renal disease was detected in 21 of 56 progeny from a specific line of inbred Norwegian Elkhound (NE) dogs. Results of hematologic and clinical chemistry examinations revealed that minor differences existed between affected and nonaffected NE dogs. Of 21 NE dogs with renal disease, 3 had persistent glucosuria without hyperglycemia. The 21 affected dogs had impaired ability to concentrate urine. According to renal function tests, glomerular filtration rate of normal NE dogs was less than that of normal mixed breed dogs. Although a few affected NE dogs excreted large amounts of amino acids in urine, statistically significant differences did not exist between normal and affected NE dogs with regard to alpha-amino acid nitrogen content of their plasma or urine. By paper chromatographic separation techniques, free amino acids of plasma, urine, and extracts of liver and kidney were not qualitatively different for mixed breed dogs, normal NE, and NE with renal disease. Statistically significant differences were not detected between serum calcium concentrations of normal and affected NE dogs. In NE dogs with renal disease, there was significant hypercalciuria, but a few normal dogs excreted more than did some dogs with disease. Blood pressure values of normal mixed breed dogs and affected NE dogs were similar. It was concluded that hematologic and blood chemical abnormalities, derangement of amino acid or calcium metabolism, and hypertension were not associated with renal disease in these NE dogs.
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PMID:Familial renal disease in Norwegian Elkhound dogs: physiologic and biochemical examinations. 94 38

In five patients with chronic renal failure, rapid correction by dialysis of hypertension and/or high blood urea levels provoked acute neurological disorders, followed by slowly reversible neuropsychiatric disturbances. Focal EEG alterations were noted in three patients with normal carotid angiograms. Our cases differed from those usually described as suffering from the dialysis disequilibrium syndrome because of their duration, the severity of mental disturbances, and the asymmetrical pattern of EEG abnormalities. We propose that the symptoms observed could be due to cerebral ischemia. This possibility emphasizes the importance of limiting the duration and efficiency of the first dialyses in patients with severe hypertension and high nitrogen retention, especially if high performance dialyzers are used.
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PMID:Unusual aspects of the dialysis disequilibrium syndrome. 95 37

A total of 117 patients with renovascular hypertension operated upon by employing reconstructive surgery upon renal arteries for producing hypotensive effect and restoration of renal functions were examined. Examination was made before surgery, in the near (up to 6 months) and remote post-operative periods (after a lapse of up to 10 years time). Soon after the operation persistent normalization of the arterial pressure was recorded in 78 (67 per cent) of 117 patients, improvement supervened in 12 per cent of the cases, and a positive hypotensive effect could be achieved in 92 or 79 per cent of the patients. The immediate normalization and improvement in the evolution of arterial hypertension continue, as a rule, also late after surgery. Following reconstructive operations on the renal arteries with normalized arterial pressure or its improvement the great majority of the patients demonstrated re-establishment or a significant improvement of both the summary (filtration, concentration and even nitrogen-excretory) and individual renal functions (as shown by the results of radioisotope renography with I131 hippuranium and excretory urography. In patients with malignant course of arterial hypertension successful reconstructive surgery was followed by a tendency toward retrograde development of the arterial hypertension malignancy.
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PMID:[Kidney function after reconstructive operations on the renal arteries in renovascular hypertension]. 103 Jul 51

1. A group of patients with essential hypertension was divided into three categories on the basis of the plasma renin activity. 2. There was no correlation between the plasma renin activity categorized as high, normal or low and the duration of hypertension, the incidence of left ventricular enlargement, the blood urea nitrogen, serum creatinine, cholesterol or uric acid respectively. 3. Analysis of data showed that the incidence of cardiovascular events in the hypertensive population correlated with the plasma renin activity only in combination with known risk factors.
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PMID:Plasma renin activity and cardiovascular disease. 107 64

Available clinical evidence indicates a high prevalence of hyperuricemia in patients with essential hypertension; this becomes accentuated with diuretic therapy. Since there is an association of hyperlipidemia with hyperuricuria and hypertension and since hyperuricemia is a feature of diuretic therapy, we explored whether these relationships might be provoked by prolonged diuretic therapy. Eighteen male patients with uncomplicated essential hypertension of mild severity were treated for 9 months with hydrochlorothiazide and supplemental potassium chloride, 100 mg and 45 mEq/day, respectively. Arterial pressure, renal function, and serum electrolyte, uric acid, blood glucose, and lipid concentrations were measured several times before and during therapy. Arterial pressure remained significantly reduced during therapy (P less than 0.001); this was associated with reduced serum potassium (P less than 0.01) and increased blood glucose and serum uric acid concentrations (P less than 0.005, P less than .025, respectively). Blood urea nitrogen, serum creatinine, sodium, cholesterol and triglyceride levels did not significantly change with treatment. Thus, although diuretics increase serum uric acid and blood glucose, their effect on serum lipid concentration is negligible.
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PMID:Effects of diuretics on lipid metabolism in patients with essential hypertension. 107 5

Twenty-six uremic patients - serum urea nitrogen (SUN) 110 MG/100 ml plus or minus 22.8 (mean plus or minus SD), serum cretinine (S-Creat) 13.2 mg/100 ml plus or minus 2.27, ratio SUN/S-Creat 8.6 plus or minus 2.26, and endogenous creatinine clearance (Ccr) 3.86 plus or minus 1.41 ml/min - were treated for three months or longer with an unselected protein-poor (16-20 g protein/day) diet with oral supply of the essential amino acids including histidine in high doses as coated tablets. The amino acids were instituted after an initial diet only period (mean 0.4 months). The average treatment time was 8.4 months (range 2.7-33.6). An improvement of the general condition was obtained, persisting for several months. SUN and SUN/S-Creat decreased on the diet alone, continued to decrease after one month, and increased slightly again after three months of treatment, but did not reach the initial levels for several months in spite of an almost doubled nitrogen intake. S-Creat increased after six months indicating a further deterioration of the renal function. In patients with initially low serum total protein (smaller than 6.5 g/100 ml, 9 patients), albumin (smaller than 3.5 g/100 ml, 10 patients), and total iron-binding capacity (smaller than 260 mug/100 ml, 11 patients) the values increased after one month on amino acids and were thereafter stable. No signs of bleeding tendency, progressive muscle atrophy, or progressive peripheral neuropathy were observed. - Five patients died due to cardiovascular maladies. A further 13 patients were withdrawn for medical reasons (overhydration, 4 patients; hypertension, 1 patient; nausea and vomiting, 7 patients; and pericarditis, 1 patient). - The renal function improved in one patient. Four patients received home dialysis training, three a kidney transplant. - The results indicate that it is possible to keep severely uremic patients free from uremic symptoms, counteract protein depletion, and even improve the nutritional status during long-term treatment with an unselected protein-poor diet supplementd with essential amino acids.
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PMID:Treatment of chronic uremic patients with protein-poor diet and oral supply of essential amino acids. II. Clinical results of long-term treatment. 114 44

The experiments we described in this paper demonstrated that the myocardiac lesions without hypertension could be produced by renal failure in rabbits; after this experimental renal failure, increase in blood urea nitrogen and various functional and morphological changes suggestive of heart lesions appeared. The main structural changes in the heart were cellular edema with dilatation of the sarcotubular system, destructive changes of the mitochondria and contractile elements, and coagulative degeneration. These myocardiac lesions are induced by renal failure, and are probably caused by electrolyte imbalance, metabolic disorder, and/or hemodynamic abnormality rather than by hypertensive or toxic factors.
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PMID:Myocardiac changes in experimental renal failure--a light and electron microscopic study. 115 92

This article reports the case of a rapidly severe stenosis of the right renal artery, causing uncontrolled hypertension. After failure of a percutaneous transluminal renal angioplasty, which provoked the thrombosis of the vessel, a surgical revascularization was performed after +/- eighteen hours of renal ischemia. Blood pressure, blood urea nitrogen and serum creatinine returned to normal values. A dramatic improvement of the right renal function was attested at the hippuran scintigraphy after a dose test of captopril. The results of renographic studies obtained in this clinical case underline the role of the captopril radionuclide test in detection and follow-up after treatment of renovascular hypertension.
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PMID:Role of the captopril test in renovascular hypertension: a case report. 144 67


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