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)

The spontaneous changes in renal plasma flow (RPF) were determined by sodium paraamino hippurate clearance (CPAH) in the individual kidneys of 71 patients with essential and secondary hypertension. These changes were expressed as changes in CPAH and as changes in CPAH per 100 ml Glomerular Filtration Rate (GFR = inulin clearance) for every individual kidney. Sixteen normal subjects were used as control. The RPF changes were measured between two consecutive 10 minute clearance periods during separated kidney function tests. In all the hypertensive groups studied, when RPF variability was expressed per 100 ml GFR, the variability was found to be two to five times greater than in normals. This findings suggests that in the hypertensive state the blood flow changes in the kidney are more labile than in normals. The high lability of renal blood flow could reflect and abnormality in renal vascular tone. This abnormality could be an important factor in the pathogenesis and maintenance of high blood pressure.
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PMID:High renal plasma flow lability in the kidneys of hypertensive patients. 68 55

Renal function was serially investigated during the development of hypertension in a 12.8-year-old girl with chronic glomerulonephritis. Clearances of inulin (CIn) and para-aminohippuric acid (CPAH), filtration fraction, and sodium excretion were measured during hydropenia and isotonic saline volume expansion. Blood pressure was initially labile, but after a few years fixed hypertension developed, and antihypertensive treatment with propranolol was started. During the early stages of hypertension, the filtration fraction during hydropenia was reduced, but the natriuresis during volume expansion was normal. When the hypertension was fixed, glomerular filtration rate, CPAH, and filtration fraction were normal, but the natriuresis was exaggerated. Antihypertensive treatment only partially corrected the natriuresis.
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PMID:Changes in renal function during the development of hypertension and effects of antihypertensive treatment. A case report. 143 10

The renal impairments were studied clinicopathologically in 57 patients with progressive systemic sclerosis (scleroderma). Proteinuria, hematuria, azotemia and hypertension, used as markers for renal involvements, were observed in 3 (5.3%), 4 (7.0%), 2 (3.5%) and 6 patients (10.5%) respectively, at the initial examination. Hypertension was increased 2.6 times at the last observation, although the incidence of other three markers have not changed during the follow-up period. Finally, 17 out of 57 patients (29.8) revealed more than one of these clinical markers throughout the study. The decrease of GFR (CThio) was noticed in 3 out of 36 cases (8.3%), however that of RPF (CPAH) in 11 of 36 patients (30.6%), including 5 without abnormal clinical markers. Histological studies were performed in 12 patients. One showed crescentic glomerulonephritis, two membranous nephropathy, and the remaining 9 minor glomerular abnormalities. On the other hand, the vascular changes such as intimal proliferation of interlobular arteries were frequently observed. The frequency of pulmonary involvements, skin ulcer and gastro-intestinal involvement in the patients with renal lesions were not significantly different from that of the non-renal group. The level of RPF was significantly lower in the patients with skin ulcer than that of those without skin ulcer. No significant difference was noticed in the frequency of renal involvements between the patients with or without anti-Scl-70 antibody.
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PMID:[Clinicopathological studies of renal disorders in patients with progressive systemic sclerosis]. 174 19

Acute selective intrahepatic hypertension (IHH) is associated with the renal tubular retention of sodium in volume expanded dogs. To determine if acute selective IHH per se, without volume loading or ascites sequestration, would blunt the natriuretic response to i.v. infusions of atrial natriuretic peptide (ANP), 175 ng/kg/min of the 1-28 rat peptide was infused into 6 hydropaenic dogs where intrahepatic hydrostatic pressures were normal, and again, following the portal infusion of histamine, a maneuver known to selectively increase postsinusoidal resistance, within the hepatic microcirculation and so raise intrahepatic sinusoidal pressure. In 6 healthy dogs, while histamine 4.0 micrograms/min free base on average was being infused into a femoral vein, the infusion of ANP increased sodium excretion by 168 microEq/min, compared to 160 microEq/min when the same dose of histamine was being infused into the portal vein (portal pressure increased by 46% or 6 cm H2O). These changes in sodium excretion were not significantly different. Urine flow rate increased by 1.5 ml/min in the control phase and by 1.4 ml/min during intrahepatic hypertension (NS). Although the ANP infusion did not alter GFR or CPAH during the control phase, during IHH, ANP caused GFR to rise significantly by 20%, while there was no change to CPAH. Despite the increment in GFR, the natriuretic response during IHH was not different from that observed during the control phase of the study. We conclude that acute IHH per se does not blunt the renal tubular natriuretic response to ANP.
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PMID:Response to atrial natriuretic peptide in dogs with acute selective intrahepatic hypertension. 253 78

Systemic and renal hemodynamics including split renal function tests were studied in 41 patients with renovascular hypertension (RVH) related to unilateral stenosis of main renal artery in comparison to 36 subjects with essential hypertension (EH). The two populations were matched for age, sex, body surface area, and systemic arterial pressure. Cardiac output and total peripheral resistances were similar in both groups, with total peripheral resistances increased in comparison to normal values (P less than .001). Patients with EH had a decreased blood volume (P less than .01) with a normal cardiopulmonary blood volume. Patients with RVH had a normal blood volume with an increase in cardiopulmonary blood volume (P less than .02). The para-amino hippurate clearance (CPAH) was decreased in EH. The decrease was similar in the right (160.3 +/- 56.9 mL/min/m2) and left kidneys (158.7 +/- 45 mL/min/m2). The inulin clearance (Cin) was similar in both kidneys (35.2 +/- 12.5 v 33.6 +/- 11.6 mL/min/m2). In addition, in EH, CPAH was negatively correlated with blood pressure (P less than .01). In patients with RVH, CPAH of the "stenotic" kidney was reduced (91.5 +/- 47.8 mL/min/m2) as well as Cin (22.9 +/- 9.3 mL/min/m2). In contrast a significant increase in CPAH (194.1 +/- 63.8 mL/min/m2) and Cin (47.6 +/- 12.6 mL/min/m2) was observed in the contralateral kidney. Kidney function (CPAH and Cin) was not correlated with blood pressure in the "stenotic" kidney. The CPAH and Cin of the nonstenotic kidney were positively and significantly correlated with systemic arterial pressure (P less than .001). The Cin was positively correlated with CPAH in all kidneys in RVH or in EH.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal hemodynamics in patients with sustained essential hypertension and in patients with unilateral stenosis of the renal artery. 270 91

This prospective, double-blind, multicenter study compared enalapril plus hydrochlorothiazide with standard triple therapy (STT; hydrochlorothiazide, timolol, and hydralazine) with regard to safety, tolerability, antihypertensive efficacy, and effect on renal function in 75 patients with documented renovascular hypertension. Both groups showed a significant mean decrease in systolic and diastolic blood pressure during the double-blind study, with the enalapril group showing a mean 12 mm greater decrease in systolic blood pressure as compared to STT (less than 0.05). Effective treatment of diastolic hypertension was noted in 96% of the enalapril group as compared to 82% on STT (p less than 0.05). STT failure was seen exclusively in patients with bilateral renal artery stenosis of high grade and frequently in association with impaired renal function. cPAH, a measure of effective renal plasma flow, showed a significant increase in the enalapril group, as compared to the STT (p less than 0.05). In contrast, there was a bimodal response of CIn (GFR): 80% of patients in the enalapril group showed no significant change while 20% (10 patients) showed a mean decrease of 28% along with a 12% increase in CPAH (p less than 0.01). No acute renal failure or toxic side effects were noted in the enalapril group. Enalapril plus hydrochlorothiazide is very effective in treating renovascular hypertension and is without significant toxic side effects. The self-limited increase in serum creatinine seen in 20% of renovascular hypertensive patients receiving enalapril and hydrochlorothiazide may identify a subset of patients with unilateral or bilateral high grade renal artery stenosis who should be treated with angioplasty or operative intervention.
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PMID:A comparison of enalapril plus hydrochlorothiazide with standard triple therapy in renovascular hypertension. 301 2

Use of converting-enzyme inhibitors in patients with hypertension and bilateral renal artery stenosis or renal artery stenosis in a single kidney may be complicated by acute renal failure (ARF). The aim of this work was to find a simple test to predict this accident. PAH clearance (CPAH), Inuline clearance (CIn) and Glomerular Filtration Fraction (GFF) were measured before and three hours after a single oral dose of Captopril (50 mg) in 7 hypertensive patients (sodium intake = 6 g/24 h). All these patients presented significant stenosis (greater than 60%) of the artery of a transplanted kidney (5), of a single kidney (1) or a bilateral renal artery stenosis (1). During the following three days, 50 mg captopril was given twice a day. ARF with creatinine serum level higher than 300 mumoles/l was seen in 4 patients (Group II); in 3 patients (Group I) creatinine serum level didn't change. Values measured before the single dose of captopril and variations after three hours are reported in the table: (Table: see text). Before captopril, in Group II CPAH and CIn are lower and GFF is higher, but these is not significant difference between the two groups. After Captopril CIn and GFF are significantly decreased in Group II (29.1 and 36.6% vs 7.8 and 10%). These results allow two conclusions: 1) Basal values of Glomerular Filtration Rate plasma flow and filtration fraction are not predictive parameters for acute renal failure after captopril therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Predictability of post-captopril acute renal failure in hypertension with renal artery stenosis of a single kidney or bilateral stenosis]. 309 6

We studied 99 living related allograft donors with follow-up information of at least 10 years and the 50 recipients who had successful outcomes. Recipients were younger and had significantly lower blood pressures at follow-up than their donors. Borderline and definite hypertension were present in 22.2% and 4.0% of donors prior to donation, in 14.4% and 21.1% of donors at follow-up, and in 2.0% and 18.0% of the 50 recipients at follow-up. Age, relative weight, and mean arterial pressure (MAP) prior to donation were the key variables in predicting the follow-up ranked MAP of the donors. CPAH prior to donation was inversely correlated with the age of the donors and, indirectly, with the follow-up MAP. Donor CPAH prior to donation was significantly correlated with the renal allograft function of the recipients but not with the recipient ranked MAP at follow-up. No correlation of the ranked MAP or blood pressure outcome categories between donors and recipients was found. We conclude that donation of one kidney can accelerate the development of hypertension in those donors with predisposition to develop hypertension. In addition, the predisposition of the donors to develop hypertension and their age, within the range observed in the study, does not significantly influence the long-term blood pressure status of the recipient.
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PMID:Blood pressure determinants in living-related renal allograft donors and their recipients. 330 7

The effect of captopril up to 450 mg/day on blood pressure and renal function were investigated during sustained treatment of 10 patients whose severe hypertension had not responded to previous therapy. All the patients were kept on diuretics and most of them on beta-blockers, too. A control determination of glomerular filtration rate (GFR) and para-aminohippuric acid clearance (CPAH) was performed during the prior treatment. The effect of the addition (or substitution) of captopril were assessed after an average of 25 days (short-term) and 26 weeks (long-term). Short-term treatment produced a 15.5% decrease in mean blood pressure and interindividually variable effects on renal function. On average GFR was somewhat lower and CPAH slightly higher than the control values (not significant). This pattern is quite similar to the effects of most other antihypertensive drugs. On long-term therapy GFR rose by a mean of 9% (NS) and CPAH by 17% (p less than 0.02). However, in a patient who developed a captopril-induced nephrotic syndrome, GFR dropped to 56% and CPAH to 50% of the control values. In another patient a transient rise in serum creatinine accompanied a severe drug reaction.
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PMID:Long-term effects of captopril on renal function in hypertensive patients. 642 13

Renal prostaglandins play a role in the control of renin release during chronic sodium depletion, during the acute phase of renovascular hypertension and in experimental low output heart failure in conscious dogs. However, with marked inhibition of the renin-angiotensin system, the adrenergic nervous system and the renal prostaglandins, PRA was still 17 times normal during chronic sodium depletion. After blockade of the adrenergic nervous system and the renal prostaglandins, PRA was 10 times normal during the acute phase of one-kidney renovascular hypertension. These findings demonstrate that other important mechanisms, possibly both the renal vascular receptor (so-called baroreceptor) and the macula densa, were involved. Both PGI2 and PGD2 given intrarenally increased renin release in both filtering and nonfiltering kidneys, but PGI2 was more potent than PGD2. Available evidence favors a role of PGI2 and it seems likely that the site of action is on the JG cells. Indomethacin produced a profound drop in CCr and CPAH during sodium depletion and in experimental heart failure which demonstrates an important role for the renal prostaglandins in the control of renal arteriolar tone. An important incidental finding is that renal denervation combined with propranolol administration decreased PRA from very high levels to normal in 50% of the dogs with experimental low output heart failure and a concurrent striking natriuresis occurred.
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PMID:Renal prostaglandins, renin release, and renal hemodynamic function in high renin states. 700 Apr 61


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