Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pathophysiological characteristics and long-term prognosis were studied retrospectively in 69 malignant hypertensives associated with grade III or IV retinopathy and the diastolic blood pressure greater than 120 mmHg. Thirty three (48%) cases had essential hypertension (EHT) as the underlying disease, 26 (38%) as chronic glomerulonephritis (CGN), and the remaining 10 (14%) as others including chronic pyelonephritis, renovascular hypertension, hydronephrosis, multiple calyceal diverticula, and unknown original disease. The role of the renin-angiotensin system in malignant hypertension was investigated by measuring plasma renin activity (PRA) and determining the blood pressure response to angiotensin (ANG)II antagonist, (Sar1, Ile8) ANG II. Basal PRA was significantly higher in the EHT group than the CGN group, and the ANG II antagonist-induced reduction of blood pressure was only evident in the former group. The regression analysis revealed that PRA was linearly correlated with both mean blood pressure (MBP) and serum creatinine prior to antihypertensive treatment in the EHT group but not in CGN patients, although there was inverse correlation between PRA and serum sodium in both groups. Therefore, the renin-angiotensin system seems to play a significant role in elevating blood pressure and deteriorating renal function in malignant hypertension developed from EHT, while it is less important in that from CGN. The 5-year survival rate was 90% in total 69 patients with malignant hypertension, while the 5-year renal survival rate defined as the probability of surviving without maintenance hemodialysis was 37%, indicating that the treatment with hemodialysis as well as antihypertensive drug therapy contributed to an improvement of prognosis of malignant hypertension. The EHT group showed a poor prognosis for life compared with the CGN group, while in the latter group most patients rapidly developed endstage renal failure. Although the pretreatment serum creatinine levels were matched, the renal function more rapidly deteriorated after development of malignant hypertension in the CGN group than did in the EHT group, indicating renal survival rate to be shorter in the former group. Hence, underlying diseases may affect the long-term prognosis of malignant hypertension. The results obtained from this study suggest that the pathophysiological characteristics of malignant hypertension are different and its long-term prognosis is varied by underlying diseases such as EHT and CGN.
 ...
PMID:[Pathophysiology and prognosis in malignant hypertension: comparison by underlying diseases]. 251 35

Erythrocyte Na-Li countertransport was determined in 42 patients with essential hypertension (EH), 36 patients with hypertensive chronic diffuse glomerulonephritis, 47 patients with chronic pyelonephritis, 19 patients with renovascular hypertension and 9 patients with primary aldosteronism (PA). None of PA patients was treated with verospiron. Individual assessment of Na-Li exchange was made in 15 patients with nonspecific aorto-arteritis (NAA), untreated by steroid hormones, and in 2 glucocorticoid-treated NAA patients. Na-Li exchange parameters were compared before and after surgery in 7 patients with arterial hypertension (AH). Mean rate of Na-Li countertransport was nearly twice as high in EH patients as compared to the respective rate in patients with renal AH, whereas the difference in mean countertransport rates was not significant between EH and PA patients. Increased Na-Li exchange rate went down to normal values in a PA patient, while postoperative hydrocortizone treatment increased this rate in a patient with pheochromocytoma. In the remaining patients with symptomatic hypertensions (renovascular hypertension, pyelonephritic granular kidney, aortic coarctation, pheochromocytoma), Na-Li exchange remained unchanged after surgery. The rate of Na-Li exchange was increased in prednisolone-treated NAA patients, as compared to NAA patients receiving no glucocorticoids. The level of Na-Li exchange was stable over 9-18 months in AH patients with normal plasma aldosterone levels. No effects of obsidan, corinfar, clophelin, furosemide, hypothiazide and triampur on Na-Li exchange were identified.
 ...
PMID:[Sodium and lithium transport and steroid hormones of the adrenal glands]. 271 20

Severe hypertension was diagnosed in a dog that initially was referred for evaluation of visual deficits and retinal hemorrhage and eventually was donated for medical treatment of hypertension. Initial blood pressure measured by direct methods was markedly high (systolic, 275 mm of Hg; diastolic, 170 mm of Hg). Measures of renal function were within normal limits, with the exception of hypotonic urine. A test protocol was designed to exclude possible secondary causes of hypertension; negative results of such tests allowed the diagnosis of essential hypertension. The consistency of the hypertension and its response to medical control were studied for 5 years. Blood pressure while the dog was untreated during those years was 240 +/- 24 mm of Hg (systolic) and 146 +/- 14 mm of Hg (diastolic). Plasma renin activity was within normal limits, and the response of the renin-angiotensin system to varied salt intake was normal. The most effective medications used to lower blood pressure were propranolol and captopril, both of which were more effective than salt restriction alone. Five years after the diagnosis of hypertension, the dog was euthanatized because of chronic renal failure secondary to pyelonephritis. Hypertension was less severe as the condition progressed into chronic renal failure. Complete necropsy did not reveal an obvious cause of the hypertension, and histopathologic changes were limited to the cardiovascular system, eyes, and kidneys.
 ...
PMID:Essential hypertension in a dog. 275

A total of 530 patients with a variety of hypertensive conditions, including 476 patients with labile and stable essential hypertension, 40 with hypertensive chronic diffuse glomerulonephritis and hypertensive chronic pyelonephritis, and 14 with vasorenal hypertension, were investigated. Structure and function of target organs (the heart and the kidneys) were assessed by means of echocardiography (530) and intravital morphologic studies of renal biopsy specimens (89). A heterogeneous nature of hypertrophic developments associated with essential hypertension was demonstrated, with adequate, inadequate, disproportionate and excessive hypertrophy identified, while no correlation could be found between the kind of hypertension and the degree and nature of hypertrophy. Renal morphologic changes were also shown to be heterogeneous in labile and stable arterial hypertension, and early involvement of the renal mechanism presenting as structural changes was found to be possible.
 ...
PMID:[Lesions of target organs in arterial hypertension]. 294 50

Echocardiographic investigation of 110 patients with different forms of stable arterial hypertension demonstrated a moderately close correlation between left-ventricular myocardial weight, and systolic and diastolic arterial blood pressure in patients with essential hypertension and chronic diffuse glomerulonephritis, and a weak correlation between left-ventricular myocardial weight and systolic pressure in patients with renovascular hypertension and chronic unilateral or predominantly unilateral pyelonephritis. Inadequate left-ventricular hypertrophy has similar incidence (15-20%) in patients with different forms of arterial hypertension, whereas excessive hypertrophy only occurs in patients with essential hypertension. The frequency of asymmetrical hypertrophy differs in the two groups.
 ...
PMID:[Characteristics of left ventricular hypertrophy in patients with different forms of arterial hypertension based on echocardiographic data]. 315 74

Erythrocyte Na-Li countertransport was assessed in 99 patients with various arterial hypertensions. Mean Na-Li countertransport rate was 476 +/- 43 mumol/l 1 cells/hour in essential hypertension, or nearly twice as high as mean rates for hypertensive chronic diffuse glomerulonephritis, chronic pyelonephritis, renovascular hypertension and nonspecific aortoarteritis, primarily affecting extracranial arteries. In 2 patients, operated on for renal arterial stenosis, Na-Li countertransport was high and the operation had no hypotensive effect, suggesting that renal arterial stenosis was combined with essential hypertension. In 1 patient, the original diagnosis of chronic diffuse glomerulonephritis and aldosteronoma was not confirmed at surgery and renal biopsy, and the diagnosis of essential hypertension was made instead.
 ...
PMID:[Clinical importance of determining Na-Li countertransport in patients with arterial hypertension]. 319 50

Novel approaches to managing refractory arterial hypertension (AH) have been tested in 130 patients aged 28 to 59 years with severe or malignant hypertension. Hemosorption was performed in 70 patients in whom AH was caused by chronic diffuse glomerulonephritis (49 cases) or chronic pyelonephritis (21 cases) accompanied by the appearance of chronic renal failure. In all patients, blood pressure after hemosorption decreased by 15% to 16% on the average, resulting in progressively improved renal function and a nearly 2.0-fold reduction in plasma aldosterone concentration (PAC), and allowing the doses of antihypertensive drugs to be reduced. Plasmapheresis was performed in 31 patients with refractory severe or malignant AH due to essential hypertension or parenchymatous diseases of the kidneys. After two to four plasmapheresis sessions with up to 2 L of plasma exchanged, blood pressure dropped by 24% compared to baseline while the doses of antihypertensive drugs were diminished and some were discontinued completely in several cases. Analysis of the sensitivity to antihypertensive drugs after plasmapheresis using the rosette technique revealed a significant decrease in the number of rosette-forming cells. The level of angiotensin II and urinary excretion of aldosterone-18-glucuronide declined progressively by nearly 50% after plasmapheresis, correlating with the antihypertensive effect of plasmapheresis. In 32 patients with severe AH complicated by refractory cardiac failure, isolated ultrafiltration was used. After one to eight sessions and the removal of 1.0 L to 35.8 L of fluid, the signs of cardiac failure diminished, the blood pressure level responded to drug therapy, and the PAC level decreased significantly. Although the mechanisms of the antihypertensive actions of hemosorption, plasmapheresis, and isolated ultracentrifugation are still not completely elucidated, these data suggest that hemosorption may act by removing nitrogenous residues from the body and reducing PAC, plasmapheresis by deblocking receptors for antihypertensive drugs and reducing the concentration of angiotensin II and the synthesis of aldosterone in the body, and isolated ultrafiltration by eliminating hyperhydration and edema of the parenchymatous organs.
 ...
PMID:Extracorporeal methods in the management of severe and malignant arterial hypertension. 324 17

Na-Li-countertransport was determined in 117 patients aged 16-17. The main groups included 22 patients with essential hypertension accompanied by minor urinary syndrome; 12 patients with hypertensive form of chronic diffuse glomerulonephritis; and 21 patients with chronic pyelonephritis either with or without urinary syndrome who exhibited no severe alterations in function, shape and structure of kidneys according to instrumental findings. 23 patients with chronic diffuse glomerulonephritis and 24 patients with chronic pyelonephritis reliably diagnosed by instrumental methods as well as patients with essential hypertension without urinary syndrome were included into groups of comparison. Patients with essential hypertension from both groups had individual Na-Li-countertransport values over 300 mumol/l RBC/hr; nevertheless, mean values of countertransport as well as systolic and diastolic BP levels were higher in the main group. Individual Na-Li-countertransport rates in patients with parenchymatous renal diseases did not exceed in overwhelming majority of cases 300 mumol/l RBC/hr. Main groups and groups of comparison did not differ in mean values of countertransport.
 ...
PMID:[Clinical value of determining Na-Li countertransport in the diagnosis of arterial hypertension associated with minor urinary syndrome]. 340 39

Forty-five patients with high arterial hypertension (AH) refractory to hypotensive therapy were treated with 3 or 4 prostaglandin E2 (PGE2) infusions (Prostenon). Twenty-two of those had the malignant AH syndrome. The hypotensive effect of prostenon was most pronounced in patients with essential hypertension, less marked in those with chronic glomerulonephritis and pyelonephritis and virtually nonexistent in cases of renovascular hypertension. It persisted until the discharge in most patients, and for several months in some. In severe AH, prostenon improved blood supply to the brain, kidneys and, less notably, the limbs, normalized venous dilatability and the cardiac index, brought down total peripheral resistance, particularly in cases where pretreatment values had been high, reduced platelet aggregation 1.8-fold, and contributed to reverse development of eyeground changes in some patients with malignant AH syndrome.
 ...
PMID:[Use of prostenon in the treatment of severe and malignant forms of hypertension]. 347 May 53

The authors present a mathematical model for determining the separated effective renal blood flow (ERB) and a computer program which was used to determine separate parameters of the ERB in 56 patients including 35 with a unilateral lesion of the kidneys (20 patients with renovascular hypertension and 15 with unilateral pyelonephritis) and 21 patients with symmetrical renal damage (12 patients with chronic diffuse glomerulonephritis and 9 with essential hypertension). The patients with a unilateral renal lesion exhibited a significant decrease in the ERB parameters on the affected side whilst the patients with the symmetrical damage showed no significant differences in the ERB values. Following the surgical correction of the stenosing renal artery, the patients with renovascular hypertension displayed in the presence of a pronounced hypotensive effect a redistribution of the ERB with its increase on the side of the interference. A similar although less evident tendency toward the predominant increase in the ERB on the affected side was also observed in the patients with unilateral pyelonephritis. The patients with the symmetrical damage to the kidneys presented no redistribution of the ERB after the treatment.
 ...
PMID:[A method of determining separate effective renal blood flow by dynamic scintigraphy of the kidneys using I-131-hippurate]. 390 May 27


<< Previous 1 2 3 4 5 Next >>