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)

Changes in urine retinol binding protein (RBP, M(r) 21,000) excretion and other indices of renal tubular damage were investigated in the patients with non-insulin dependent diabetes mellitus (NIDDM). Changes in urine RBP excretion were well paralleled with those of urine NAG excretion. In RBP-negative patients, the subjects with hypertension (systolic blood pressure > or = 140 mmHg or diastolic blood pressure > or = 90 mmHg) showed higher beta 2-microglobulin (beta 2-MG) excretion and albumin (Alb)/Cr ratios than normotensive ones. In addition, both urine beta 2-MG excretions and Alb/Cr ratios were significantly increased in RBP-positive patients. The measurement of urine RBP excretion may have an additional role in the diagnosis of renal tubular dysfunction in diabetic patients.
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PMID:Changes in urinary retinol binding protein excretion and other indices of renal tubular damage in patients with non-insulin dependent diabetes. 1803 43

The measurement of small but abnormal amounts of albumin in urine is important in evaluating kidney disease in people with diabetes mellitus, hypertension, or possible adverse health effects from exposure to nephrotoxins. Routine laboratory methods for measuring albumin are not sensitive enough to measure the amounts that are significant in urine (less than 30 mg/L). In our laboratory we used three immunoassays for measuring urinary albumin: enzyme-linked immunosorbent assay (EIA), radioimmunoassay (RIA), and immunoturbidimetric assay (IT). We calculated the CVs of the three methods, investigated potential interfering substances at three times their normal concentrations, and stored urine under different conditions to find the best way to protect the sample until assay. The potential interferents we checked were transferrin, urea, beta 2-microglobulin, retinol-binding protein, creatinine, kappa and lambda light chains, IgG, hemoglobin, ketone, and glucose. The stability study involved two study temperatures (-20 and -70 degrees C) and four treatments (centrifuging or filtering, before or after storage). We found the following: the RIA had the lowest CV; the results from the interference study showed no interference from normal physiological concentrations of the substances investigated; storage at -70 degrees C regardless of the treatment should be adequate to prevent loss of albumin immunoreactivity.
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PMID:Considerations when measuring urinary albumin: precision, substances that may interfere, and conditions for sample storage. 176 88

During contact between blood and dialysis membrane after the first 20-30 minutes of haemodialysis there occur the complement activation, ++intra-dialysis thrombocytopenia and leucopenia, especially neutropenia following their degranulation, which results in liberation of a number of proteases and inflammatory reaction mediators and an increased production of active oxygen compounds and peroxide radicals. This is followed by the appearance of thrombocyte-leucocyte aggregates and a decrease of ++intra-dialysis lung diffusion capacity. The clinical consequences of the blood-dialysis membrane interaction exhibit an increased permeability of pulmonic capillaries, pulmonic hypertension and hypoxemia, which might bring about vasogenic respiratory distress syndrome. The remote consequence is dialytic amyloidosis that follows increased generation and accumulation of beta 2-microglobulin. All of the above disturbances occur with cuprophan membranes more significantly that with other dialysis membranes. The blood--dialysis membrane interaction also incorporates the anaphylactic reactions, in some cases occurring when the new dialyzers are used, due to hypersensitivity to ethylene oxide used in sterilisation and the changes due to tissular accumulation of plastieizers rinsed out of the biomaterials during haemodialysis.
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PMID:[Interaction between blood and dialysis membrane]. 182 94

Hypertensive diabetic patients are particularly prone to renal function impairment. A total of nine out-patients with diabetes and hypertension were, therefore, entered into this single-blind uncontrolled study on the effects of 50 mg/day atenolol on reducing blood pressure and preserving normal kidney functioning. Treatment and evaluations were continued for 12 months. Serum beta 2-microglobulin concentration was used as the index for measuring renal impairment. Atenolol significantly reduced heart rate, systolic and diastolic blood pressure, and serum beta 2-microglobulin concentrations compared with baseline. Plasma glucose and glycosylated haemoglobin levels were unchanged, and blood urea nitrogen levels were increased slightly (non-significant). Serum creatinine showed a tendency (non-significant) to reflect the changes in beta 2-microglobulin concentration. Ways in which atenolol may act to improve kidney functioning are suggested. It is concluded that atenolol is a favourable choice for the treatment of hypertension in diabetic patients with normally functioning kidneys since, even in long-term use, normal renal functioning is preserved.
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PMID:A 1-year follow-up study on the effect of atenolol on serum beta 2-microglobulin level in hypertensive diabetic patients. 265 32

This investigation was performed in 15 adult patients: 6 with type I and 9 with type II diabetes mellitus, all with arterial hypertension. Captopril (12.5 to 100 mg daily, mean 34 mg) was administered for a month and was effective as monotherapy in all patients. The supine arterial pressure changed from: 177 +/- 19 mm Hg to 141.7 +/- 7.7 mm Hg systolic and 106 +/- 7.6 mm Hg to 87.3 +/- 5.3 mm Hg diastolic; and upright: from 162.7 +/- 16 mm Hg to 139 +/- 11.4 mm Hg systolic and from 101.7 +/- 11.6 mm Hg to 87.3 +/- 6.5 mm Hg diastolic. The differences were statistically significant (p less than 0.001). The mean blood glucose was changed significantly at the end of the study (from 11.1 +/- 3.4 mmol.l-1 to 8.1 +/- 1.0 mumol.l-1, p less than 0.001), while the daily insulin dose (respectively glybenclamide) remained unchanged. No alterations in serum creatinine, HbA1 (glycohemoglobin), urinary excretion rate of albumin, beta 2-microglobulin, glomerular filtration rate were observed during follow-up. No important change in plasma aldosterone was found, while plasma renin activity was significantly increased (p less than 0.05) as expected. No side effects were reported during the therapy. Captopril appears to be an effective and safe drug for lowering blood pressure in diabetic patients without affecting renal function.
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PMID:Captopril in treatment of hypertensive diabetic patients. Preliminary study. 266 Jun 16

This study was undertaken to evaluate the relation between the urinary excretion of guanidinoacetic acid (GAA) and other substances in hypertensive patients (6 with borderline hypertension and 29 with hypertension) and 12 normal controls. In 10 of the hypertensive patients, GAA was measured before and after 4 weeks of treatment with calcium entry blocker. In hypertensive patients the rate of GAA urinary excretion was 43.5 +/- 17-4 micrograms/min, which was much lower than in the controls (77.2 +/- 35.9 micrograms/min) (p less than 0.01). There was no significant difference among these groups in creatinine clearance (CCr), serum creatinine (Cr), beta 2-microglobulin (BMG) or in the urinary excretion of BMG, N-acetyl-D-glucosaminidase (NAG) or radiosensitive microalbumin (mAlb). The urinary excretion rate of GAA was positively correlated with CCr (r = 0.62; p less than 0.01), and negatively correlated with mean blood pressure (r = -0.49; p less than 0.01). Finally, the GAA excretion was significantly correlated with urinary NAG (r = 0.24; p less than 0.05) and serum BMG (r = -0.31; p less than 0.05), but not with urinary mAlb (r = 0.12; p less than 0.05). Ten hypertensive patients followed for 4 weeks attained their ultimate mean blood pressure reduction after treatment (from 119.3 +/- 8.0 to 101.7 +/- 13.5 mm Hg; p less than 0.001), but the GAA/Cr ratio in the urinary excretion was significantly elevated (from 0.054 +/- 0.016 to 0.070 +/- 0.02; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Urinary excretion rate of guanidinoacetic acid as a new marker in hypertensive renal damage. 266 50

Patients with essential hypertension, hypertonic glomerulonephritis and Conn's syndrome were examined for excretion of albumin, immunoglobulin G and beta 2-microglobulin. The results obtained were correlated with pathological changes in liver parenchyma according to biopsies withdrawn from the patients. Essential hypertension running a benign course was not characterized by pronounced changes in excretion of the above proteins. Injury to the glomerular apparatus of the kidneys in glomerulonephritis was attended by considerable rise of albumin and immunoglobulin excretion whereas injury to the tubular structures by the increase of beta 2-microglobulin excretion. It is suggested that analysis of microalbuminuria can be used in the differential diagnosis of arterial hypertension running its course in association with the minor urinary syndrome.
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PMID:[The diagnosis of hypertension (research on kidney biopsies and microalbuminuria]. 268 63

78 patients with essential hypertension (17 with borderline hypertension and 61 with hypertension) and 13 normal controls were examined to evaluate the relation between the urinary excretion rate of guanidinoacetic acid/creatinine (U-GAA/Cr), beta 2-microglobulin/creatinine (U-BMG/Cr), radio-sensitive microalbumin excretion rate/creatinine (U-AER/Cr), N-acetyl-D-glucosaminidase/creatinine (U-NAG/Cr) and renal function. There was no significant difference among these groups in creatinine clearance (Ccr), serum creatinine (Cr) or in U-BMG/Cr, U-NAG/Cr and U-AER/Cr. In hypertensive patients U-GAA/Cr was 49.2 +/- 16.7 mg/gCr, which was much lower than in controls (78.1 +/- 13.4) (p less than 0.001). The Ccr has a significant relation with U-GAA/Cr (r = 0.29, p less than 0.01) but not with U-AER/Cr, U-BMG/Cr nor U-NAG/Cr. In 44 patients, all of the above factors were investigated for 24 weeks during 4 kinds of anti-hypertensive treatment (10 with an angiotensin-converting enzyme inhibitor: A group, 11 with a beta-adrenergic blocker: B group, 12 with a Ca entry blocker: C group and 12 with diuretics: D group). In A and C group, U-GAA/Cr was elevated during therapeutic course. However, in B and D group it declined during treatment. These findings suggested that urinary excretion of GAA may be a more sensitive marker than AER, BMG or NAG in hypertension and angiotensin-converting enzyme inhibitor and Ca entry blocker can be useful in the treatment of patients with essential hypertension with renal damage.
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PMID:[Estimation of urinary excretion rate of guanidinoacetic acid in essential hypertension]. 269 98

The acute and chronic effects of pinacidil on blood pressure (BP) and renal function were investigated in 10 patients with moderate arterial hypertension insufficiently controlled by chronic beta-blockade. Acute i.v. administration of pinacidil caused a significant fall in BP of 29.9/18.3 mm Hg and, despite beta-blockade, a concomitant rise in heart rate (HR) of 21%. Renal vascular resistance (RVR) showed a marked reduction as a consequence of the fall in BP, and a transient rise in renal plasma flow (RPF). Diuresis and renal clearance of sodium and uric acid showed a parallel fall. The excretion rates of albumin and beta 2-microglobulin were also significantly reduced. Pharmacokinetic studies indicated that glomerular filtration was responsible for elimination of the parent drug, and that proximal tubular secretion was the pathway of excretion of the main metabolite, pinacidil pyridine-N-oxide. During therapy for 4 months there was no further significant reduction in BP, despite increases in the daily dose of pinacidil. The effects on HR were less conspicuous after 4 months; renal haemodynamic parameters and body weight were not significantly changed. The initial level of RVR and the initial acute reduction in this parameter appeared to be major determinants of the long-term BP response. The drug was well tolerated apart from one patient who developed slight fluid retention. However, concomitant administration of a diuretic will probably be necessary during routine use of this therapeutic combination.
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PMID:Renal effects of pinacidil in hypertensive patients on chronic beta-blocker therapy. 287 98

Patients with pyelonephritic renal scarring are at risk of developing renal failure and hypertension. We studied glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), systolic (SBP) and diastolic (DBP) blood pressure, fractional sodium, potassium and phosphate excretion, peripheral renin activity (PRA), plasma aldosterone (p-Aldo), urinary albumin excretion (U-Alb) and urinary beta 2-microglobulin excretion (beta 2-M) in hydropenia and during transition to 3% volume expansion with isotonic saline infusion in 22 female patients with renal scarring due to pyelonephritis and 9 healthy controls. The patients had significantly lower GFR, higher SBP and higher PRA in hydropenia, but there was no significant difference in RPF, FF, DBP or p-Aldo. After volume expansion, SBP, DBP, PRA and p-Aldo were significantly higher in patients than in controls. Transition to 3% volume expansion was associated with a similar increase in SBP in both patients and controls, whereas DBP increased significantly more in the patients (p less than 0.01). Volume expansion resulted in a significant suppression of PRA and p-Aldo in both patients and controls. The patients with renal scarring had the same capacity to excrete sodium and water during transition to volume expansion as the healthy controls. The renin-aldosterone system seems abnormally activated and is probably more important than hypervolemia in the development of hypertension in this group of patients.
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PMID:Role of hypervolemia and renin in the blood pressure control of patients with pyelonephritis renal scarring. 304 33


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