Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal biopsies obtained from 20 adult patients within 30 days after onset of acute renal failure with microangiopathic hemolytic anemia ("the hemolytic-uremic syndrome") were studied. Lesions were graded independently by two observers without knowledge of the clinical history. All patients who did not have refractory hypertension were treated with heparin. Ten of the patients died, and four developed end-stage renal failure requiring chronic dialysis. Six patients, however, had a relatively good outcome: two recovered completely and four developed mild-to-moderate chronic renal failure not requiring dialysis. The six patients with a good outcome had significantly less severe arterial intimal thickening on biopsy compared with the remaining patients with a poor outcome. The patients with a good outcome and those with a poor outcome did not differ in the severity of glomerular lesions. The clinical features did not allow a prediction of late outcome. These results suggest that early renal biopsies may be helpful in predicting prognosis in the "hemolytic-uremic syndrome." This clinical syndrome may occur either in apparently healthy people, or may complicate the course of a chronic essential hypertension.
 ...
PMID:Prognostic importance of vascular lesions in acute renal failure with microangiopathic hemolytic anemia (hemolytic-uremic syndrome): clinicopathologic study in 20 adults. 48 Jul 87

A 56-year-old Samoan man with a documented history of hypertension, who presented with atrial fibrillation and hypotension, quickly developed renal failure with a serum urea nitrogen of 1.370 g/L and a serum creatinine of 92 mg/L. After hydration of the patient, the creatinine value became normal in two days, the urea nitrogen in four days. The urinary creatinine output during the first 24 h of hospitalization was 3.7 g. This case illustrates the rapidity with which unusually large amounts of creatinine (more commonly seen in chronic renal failure) can accumulate and be excreted in pre-renal failure. It also reaffirms the usefulness of the urea nitrogen/creatnine ratio in evaluating the causes of azotemia.
 ...
PMID:Pre-renal azotemia mimicking chronic renal failure in a hypotensive patient. 49 10

Forty-three patients suffering from hypertension of different origin (chronic renal failure, gout, or idiopathic) were treated with propranolol (121 +/- 12 mg q.d.) plus hydrochlorothiazide (50 mg q.d.) for 75 +/- 9 days. Blood pressure did not return to normal limits in 15 patients, who were continued on the same protocol plus 10 to 50 mg oxdralazine q.d. After an average of 68 +/- 35 days blood pressure fell from 180/110 mm Hg to 145/90 mm Hg without orthostatism, significant side effects, or changes in GFR. This combination seems particularly successful since propranolol will prevent the undesired rise in cardiac output due to oxdralazine as well as the activation of the renin-angiotensin axis due to diuretics. Thus, the antihypertensive properties of each agent will be enhanced by a reduction in side effects by the associated drug, resulting in optimal blood pressure control.
 ...
PMID:Oxdralazine, a new peripheral vasodilator, combined with propranolol and hydrochlorothiazide: a rational approach to antihypertensive treatment. 53 72

The clinical course of IgA Mesangial Deposits Glomerulonephritis (MDGN) has been investigated in 178 patients for 1 to 32 years (mean 6 years) from the onset of symptoms. Impairment of renal function occurred in 28 patients, 13 of whom required RDT or died in uraemia. Hypertension was observed in 67 patients. The actuarial survival rate at ten years was 91%. A significant correlation was observed between the occurrence of renal failure and the following features: absence of episodes of gross haematuria, early appearance of hypertension, marked proteinuria and sclerosing glomerular lesions. These data suggest that IgA MDGN has generally a very prolonged course, but in a few cases may evolve, sometimes early, to chronic renal failure.
 ...
PMID:Long term follow up of IgA mesangial deposits glomerulonephritis. 60 Sep 63

Minoxidil, a new potent hypotensive agent, was used as the primary antihypertensive agent in 11 patients--10 men and 1 woman aged 35 to 54 years with severe hypertension that was refractory to treatment with maximal (or maximally tolerated) doses of conventional antihypertensive agents. Six patients had severely impaired renal function and three of them were undergoing long-term hemodialysis. The patients were given 2.5 to 40 mg/d of minoxidil for periods of 2 to 29 months. All except one who was almost anuric received propranolol and diuretics. Blood pressure was controlled satisfactorily in all patients. In two patients the hypertension became partially resistant after 1 year of treatment. The main side effects were sodium retention, tachycardia and hirsutism. Renal function remained stable or improved and hemodialysis was discontinued in two patients. Minoxidil is a remarkably potent hypotensive with relatively few side effects and seems particularly advantageous in patients with chronic renal failure.
 ...
PMID:Long-term treatment of severe hypertension with minoxidil. 60 47

During the last 6 years 33 bilateral nephrectomies have been performed for severe hypertension in patients with chronic renal failure on a dialysis program. Nephrectomy resulted in a prompt and sustained reduction in blood pressure, an improved sense of well-being and a gain of weight. Despite the fact that the mean hematocrit decreased from 25 to 18 per cent all patients thrived. The nephrectomy group showed an 85 per cent 5-year cumulative survival rate compared to 55 per cent in the non-nephrectomy group. There was 1 mortality and low morbidity. Simultaneous nephrectomy by 2 teams, using a posterior approach, proved more satisfactory than an anterior or bilateral flank apprach. The indications for and arguments against bilateral nephrectomy are discussed.
 ...
PMID:Bilateral nephrectomy for hypertension in patients with chronic renal failure on a dialysis program. 62 4

Cysts of the parathyroid glands are uncommon, and functioning parathyroid cysts that cause primary hyperparathyroidism are rare. A 63-year-old man had primary hyperparathyroidism because of cystic hyperplasia of all four parathyroid glands. He also had squamous cell carcinoma of the soft palate, chronic renal failure, hypertension, type-4 renal tubular acidosis, a hyperplastic thyroid adenoma, and hyporeninemic hypoaldosteronism. To our knowledge, this is the first patient to be described with hyperparathyroidism due to multiple parathyroid cysts. The finding of cystic involvement of all four glands supports the theory that at least some parathyroid cysts are either a result of a common embryologic defect or of retention of parathyoid secretions rather than of cystic infarction of parathyroid adenomas.
 ...
PMID:Hyperparathyroidism due to primary cystic parathyroid hyperplasia. 65 52

Some chronic renal failure patients maintained on dialysis have uncontrollable hypertension. Those with elevated renin levels require bilateral nephrectomies prior to kidney transplant to avoid nephrosclerosis. The morbidity and mortality from surgical nephrectomies are high. In 2 such patients we embolized the renal arteries with gelfoam and successfully occluded all the major vessels. One patient became normotensive. The second remained hypertensive and had increased renin levels, probably on the basis of ischemia. Subsequent surgical nephrectomies demonstrated completely occluded segmental branches but only focal areas of infarction. Collateral blood supply determines the success of the procedure.
 ...
PMID:Gelfoam embolization of the kidneys for treatment of malignant hypertension. 66 23

Study of case-notes and autopsy reports of patients with renal disease suggests that analgesic nephropathy is responsible for at least 12 per cent of cases of chronic renal failure, Between 1970 and 1975 eight new cases of analgesic nephropathy were seen annually in a population of three-quarters of a million. This is equivalent to an incidence of 490 new cases per year in England and Wales. Fifty-five patients with analgesic nephropathy were followed from one to 84 months for a total of 190 patient years. Changes in renal function were correlated with bacteriuria, hypertension and analgesic consumption. One-third of the cases had been misdiagnosed and analgesic abuse was only revealed by thorough examination of case-notes and autopsy records, together with careful questioning of patients and relatives. A number of cases had been classified as chronic pyelonephritis. The calculated survival rate at five years was 44 per cent. Mortality was related to the level of analgesic consumption and the degree of renal failure at the time of diagnosis. The prognosis was poor if serum creatinine at presentation was greater than 400 mumol/l. There was no significant correlation between deterioration in renal function and bacteriuria or hypertension. Forty-two per cent of the patients were taking analgesics for arthritis; 27 per cent had rheumatoid arthritis. Most had been taking large quantities of analgesic mixtures containing phenacetin. Renal papillary necrosis was present in only 26 per cent on intravenous urography but was found in all those examined at autopsy. Twenty thousand, two hundred and twenty-nine autopsy reports were examined for the presence of renal disease. Renal papillary necrosis was found in 0.41 per cent, and could be attributed to analgesic nephropathy in 24 per cent. In patients under 65 years of age analgesic nephropathy appeared to be a more frequent cause of death than chronic pyelonephritis. The report indicates the need for careful enquiry about analgesic consumption in all patients with renal disease, and emphasizes the importance of early diagnosis and cessation of analgesics in suspected cases of analgesic nephropathy.
 ...
PMID:Analgesic nephropathy: an important cause of chronic renal failure. 67 50

Acute renal failure, severe hypertension, and some complications of the nephrotic syndrome and chronic renal failure are the renal emergencies most frequently seen in the pediatric age group. Diagnosis of acute renal failure is based mainly upon U/P ratios of osmolality and urea as well as a negative mannitol test. Conservative medical management is useful in uncomplicated cases, whereas dialytic procedures are more effective in severe or complicated cases. The most frequent reversible complications in chronic renal failure are infections, extracellular volume changes, electrolyte imbalance and cardiovascular alterations. Intercurrent infection and vein thromboses are the most frequent complication in minimal change nephrotic syndrome and they may be a cause of death. Early diagnosis and adequate treatment are mandatory in these complications.
 ...
PMID:Renal emergencies in children. 72 76


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>