Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Late onset (3-7 yrs) post-transplant renal hypertension is usually an indication of chronic, irreversible renal damage, and is a poor prognostic sign. In a small percent of patients (10%) however, hypertension can persist for years in conjunction with excellent renal function, and the absence of any known causes of early or late hypertension. This primary hypertension does not seem related to the recipient's pre-transplant blood pressure nor to the original renal disease. Rather, the high incidence of essential hypertension in the respective living related donor suggests that either a hypertensive diathesis exists, common to donor and recipient, or a transplantable factor inherent to the graft, or both causes, predispose to late onset primary hypertension.
Proc Clin Dial Transplant Forum
PMID:Late hypertension in renal transplant recipients: possible role of the donor in late primary hypertension. 80 Oct 58

Urinary excretion of tissue kallikrein is reduced in essential hypertension. Although a similar finding has been reported in spontaneously hypertensive rats (SHR), only a few studies have been concerned with the amount of enzyme within the kidney both at the time of onset and during progression of the hypertension. We have performed an ontogenic study on the renal parenchymal values and immunoreactivity of tissue kallikrein in Okamoto SHR aged 4-78 weeks. Additionally, these two parameters were analysed in human biopsies taken from patients with hypertensive nephropathy. The enzymatic activity of renal tissue kallikrein (active and total; specifically antagonized by anti-tissue kallikrein antibodies), increased from 4 to 52 weeks in SHR when compared to normotensive Wistar Kyoto (WKY) rats; this increase was associated with a significant increase in blood pressure. In contrast, 78 weeks SHR and human biopsy tissue showed a substantial reduction in tissue kallikrein values. Also, both renal tissues showed a reduction in immunoreactivity in the cells of the connecting tubules that specifically store the enzyme. In advanced hypertension the observed reduction in tissue kallikrein was probably secondary to a loss of distal tubular mass, as a result of tubular atrophy and fibrosis. The greater values for renal tissue kallikrein in the kidney and reported reduced urinary excretion during the early phases of spontaneous hypertension may be explained by a primary defect in the mechanisms that regulate release of tissue kallikrein from the connecting tubule cells.
Nephrol Dial Transplant 1992
PMID:An ontogenic study of renal tissue kallikrein in Okamoto spontaneously hypertensive rats: comparisons with human hypertensive nephropathy. 132 Feb 31

The estimation of representative blood pressure (BP) levels is difficult in haemodialysis (HD) patients as it is not known whether pre- or postdialytic blood pressure are predictive for the average interdialytic BP. Furthermore, the day-night BP rhythm can be disturbed in HD patients. Therefore, in this study, BP was measured during the interdialytic period using non-invasive ambulatory BP measurements in four hypotensive, six normotensive, and 12 hypertensive HD patients. It was assessed whether pre- or postdialytic BP was representative for the average interdialytic BP. Furthermore, the nocturnal BP reduction was compared between HD patients, seven normotensive controls and eight treated subjects with essential hypertension. Postdialytic BP was superior to predialytic BP in predicting the average BP during the interdialytic period. BP did not differ significantly between day 1 and day 2 of the interdialytic period but increased rapidly in the hours before dialysis. Weight gain (corrected for actual body-weight) did not correlate significantly with the increment in systolic BP (r = 0.21; P = 0.2) or diastolic BP (r = -0.02; P = 0.5) during the interdialytic period. The nocturnal decline in systolic BP was significantly attenuated (P less than 0.001) in hypertensive HD patients compared with normotensive controls. The nocturnal reduction in diastolic BP was significantly less in hypotensive (P less than 0.001) and normotensive (P less than 0.001) HD patients compared with normotensive controls and in hypertensive HD patients compared with normotensive (P less than 0.001) and hypertensive (P less than 0.001) controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1992
PMID:Blood pressure during the interdialytic period in haemodialysis patients: estimation of representative blood pressure values. 132 39

Renography with [99mTc] diethylenetriaminepenta-acetate (DTPA) was performed in 26 patients with renal artery stenosis (RAS), unilateral in 15 and bilateral in 11, and in 16 patients with essential hypertension with a normal renal angiogram. Nine of the patients with unilateral RAS were restudied after a successful percutaneous transluminal renal angioplasty (PTRA), i.e. complete removal of the stenosis and a normalization of the blood pressure without antihypertensive treatment. Single-kidney [99mTc]-DTPA clearance and parenchymal mean transit time (MTT) were determined at each examination. All patients were studied on two different days using the same procedure except that captopril 25 mg was given orally before renography at the second examination. In unilateral RAS captopril reduced single-kidney [99mTc]-DTPA clearance significantly on the affected side (-42.7%, median) but not on the unaffected side (-3.2%). In bilateral RAS single-kidney [99mTc]-DTPA clearance was reduced to the greatest extent on the most affected side (-43.0%) compared with the least affected side (-17.2%). In essential hypertension no significant changes were recorded on any side (-1.5% for both). After PTRA, single-kidney [99mTc]-DTPA clearance was not significantly changed by captopril either on the previously affected side (4.3%) or on the unaffected side. MTT was significantly prolonged after captopril on the affected side in unilateral RAS and on the most affected side in bilateral RAS, whereas no significant changes were found on the unaffected side in unilateral RAS, on the least affected side in bilateral RAS, or on any side in essential hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1992
PMID:Angiotensin-converting enzyme inhibitor renography in the diagnosis of renovascular hypertension. Studies before and after angioplasty. 133 56

Anuria complicated the malignant phase of hypertension in twelve patients (ten males and two females). Five were black; five had primary hypertension; one had HBs virus angiitis; the six remaining cases suffered from previously documented renal disease, including two with Berger's disease. Renal angiography showed interruption of renal blood flow as far as the main branches of the renal artery and/or a false impression of 'cortical necrosis' and of 'renal infarcts'. In contrast, renal biopsy did not show irreversible vascular damage. Thus, anuria was mainly functional and due to active renal vasoconstriction. This was confirmed by the subsequent course; diuresis resumed after 1 week to 24 months of dialysis. Repeat angiography in six cases showed recovery of renal circulation and disappearance of 'cortical infarcts', even when plasma renin activity remained elevated and hypertension was not controlled. In one case captopril induced a new reversible episode of anuria. These observations suggest that active vasoconstriction with prolonged anuria might be due to some vasoconstrictive substance other than angiotensin II.
Nephrol Dial Transplant 1990
PMID:Protracted anuria due to active vasoconstriction in primary or secondary malignant hypertension. 211 43

The renal selectivity properties towards albumin were evaluated in ten diabetic patients with arterial hypertension before and after the pharmacological normalisation of blood pressure, and were compared to 12 subjects with essential hypertension. While all patients of the control group were normoalbuminuric during hypertension, six of the diabetic group were microalbuminuric when hypertensive and became almost normoalbuminuric after blood pressure pharmacological control. All microalbuminuric diabetic patients presented altered properties of renal selectivity as epitomised by a non-preferential urinary excretion of glycosyl albumin (GA) (urinary GA/serum GA less than or equal to 1). At variance the selectivity properties were normal in normoalbuminuric diabetic patients and in essential hypertension. It was concluded that in diabetes mellitus arterial hypertension is associated with microalbuminuria when the renal properties of selectivity are altered, but does not implicate any proteinuric effect in those cases where the GBM function is preserved.
Nephrol Dial Transplant 1990
PMID:Hypertension and renal selectivity properties in diabetic microalbuminuria. 212 64

An expert system has been integrated to the data management system of the ARTEMIS programme for hypertensive patients. The patient database, which has been used since 1975, contains the medical records of about 20,000 patients. Information is interactively entered by physicians, nurses and secretaries on video display units. The computerised medical record has replaced the traditional handwritten medical record. The database management system is used to produce different summary reports (inpatient and outpatient care) and personalized recall letters which are mailed to the patients before their appointments. Suggestions provided by the expert system include additional information to be obtained (complementary patient interrogation, biological or radiological investigations, etc.), possible causes of hypertension, and medical prescriptions. The information base allows the description of both static knowledge (in the form of a semantic network) and dynamic knowledge (in the form of production rules). The inference system sequentially uses a combination of forward and backward chaining and performs both exact and approximate reasoning. The diagnostic performance of the expert system was evaluated in 100 cases of hypertension (50 of essential hypertension and 50 of secondary hypertension. Concordance between the diagnosis proposed by the expert system and the one proposed by the specialist was achieved in 92% of secondary hypertension cases and 88% of essential hypertension cases. It is suggested that the integration of data and knowledge management might enhance the overall acceptance by medical staff of a computerised system, and facilitate the validation of a knowledge base.
Nephrol Dial Transplant 1987
PMID:Integrating management and expertise in a computerised system for hypertensive patients. 312 10

This investigation demonstrates in patients with essential hypertension an abnormal response of the adrenal glands to modulation of potassium metabolism by infusion of insulin-glucose. Similar results have been reported in anephric patients, while the inverse response of non-nephrectomised patients on dialysis corresponded to that of normal subjects. It is suggested that the abnormal response of patients with essential hypertension may be of importance to the understanding of the pathogenesis of this important disease.
Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985
PMID:Aldosterone response to modulation of potassium in patients on dialysis or with essential hypertension. 388 82

The effects of enalapril were assessed in a double-blind study versus propranolol. Twenty-two patients with essential hypertension were titrated with either enalapril (5, 10 and 20 mg twice daily) or propranolol (40, 80 and 120 mg twice daily). With propranolol blood pressure decreased from 154/101 +/- 4/1 to 146/98 +/- 5/2 mmHg (mean +/- SEM); with enalapril it decreased from 151/103 +/- 3/1 to 134/92 +/- 4/2 mmHg, both after 12 weeks of therapy. Effective renal plasma flow remained unchanged in the propranolol group whereas it increased from 413 +/- 19 to 445 +/- 27 ml/min (p less than 0.05) with enalapril. Glomerular filtration rate remained unchanged at either medication. Enalapril is an effective anti-hypertensive agent with a favourable effect on renal haemodynamics.
Proc Eur Dial Transplant Assoc 1983
PMID:Effects of enalapril on blood pressure and renal haemodynamics in essential hypertension. 631 24

The immediate antihypertensive effect of 10 mg nifedipine sublingually (nifedipine test), was measured in 19 chronic renal failure hypertensive patients on dialysis and 34 essential hypertensive patients with normal kidney function. The blood pressure decreased significantly in both groups. The minimal values were observed between 30 and 60 minutes after the sublingual administration of nifedipine. The blood pressure decreased from 178 +/- 3.3/104.0 +/- 3.9 to 136.0 +/- 4.7/87.5 +/- 5.1 mm Hg (p less than 0.001) in dialysis patients and from 176.8 +/- 4.5/107.1 +/- 2.4 to 133.0 +/- 3.0/81.7 +/- 2.2 mm Hg in essential hypertension patients (p less than 0.001). The decrease in blood pressure during the test had a significant positive correlation with the pre-test values. Thirteen hypertensive patients on dialysis and 20 essential hypertensive patients completed 2 weeks of daily oral nifedipine therapy, with a dose of 30 to 40 mg per day. The mean blood pressure at the end of the 2 weeks of treatment decreased from 179.5 +/- 4.5/108.5 +/- 5.3 mm Hg to 154.4 +/- 6.3/82.3 +/- 2.6 mm Hg (p less than 0.001) in dialysis patients, and from 176.8 +/- 5.8/110.3 +/- 2.9 to 151.3 +/- 5.3/93.5 +/- 2.6 mm Hg (p less than 0.001) in essential hypertension patients. The present results reveal that nifedipine has a powerful immediate as well as a long-term antihypertensive action in dialysis patients with high blood pressure. This effect is similar to that obtained in essential hypertensive patients.
Clin Exp Dial Apheresis 1982
PMID:Treatment of hypertension in dialysis and essential hypertension patients with nifedipine. 718 89


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