SEARCH · PubMed Health

Results for “NEPHROSCLEROSIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources

PubMed1990

[The combination of diffuse kidney lesions with different diseases of the other organs of the urinary system (the diagnosis, characteristics of the course and outcomes)].

The author characterizes in detail 4340 patients with diffuse renal lesions (chronic glomerulonephritis, renal amyloidosis, lupoid nephritis, diabetic glomerulosclerosis and nephrosclerosis) coupled with different diseases of the urinary organs including urolithiasis, cancerous and tuberculous processes, purulent diseases of the kidneys and prostatic lesions. Stage III chronic renal failure (CRF) was revealed in 2073 (57.1%) out of the 4340 patients. All of them died because of uremia. The mean lifespan of the patients was 1.6 +/- 0.1 yr. since manifestation of the concomitant process. The shortest times of CRF onset, the highest frequency of stage III CRF and the least lifespan were noted in patients with double association, particularly in those suffering from associated chronic glomerulonephritis with renal amyloidosis and urinary bladder cancer in the stage of compression with tumor of the intramural parts of the ureters, namely they were 0.6 +/- 0.1, 100% and 1.0 +/- 0.1 yr., respectively. The author holds that the main reason for such an abrupt CRF onset in patients with concomitant renal lesions of any type lies in simultaneous combined influence on the kidneys of absolutely different diseases bearing in mind their etiology and pathogenesis. Besides, according to the author's data, considerable influences on the times of CRF onset and rates of its progress are produced by both the course and stage (phase) of the development of each of the coexistent diseases. Attention is drawn to the necessity of early participation of urologists in the solution of the problems concerned with the policy of managing nephrological patients with diseases of other organs of the urinary system as well as with permanent dynamic follow-up of all the patients with concomitant processes, especially with double ones.

Diagnosis, Differential↗

PubMed1990

[The malignant hypertension syndrome: incontrovertible and questionable truths].

A total of 42 patients with malignant arterial hypertension (MAH) were examined. Of these, 32 patients had essential hypertension (26 with normal renal function and 6 with renal failure treated by programmed hemodialysis) and 10 suffered from chronic glomerulonephritis. The patients were examined for central hemodynamics, hormonal background (plasma renin activity) (PRA), plasma aldosterone and cortisol concentration. 14 patients underwent closed puncture biopsy of the kidneys. All the patients manifested high PRA associated activation of gluco- and mineralocorticoid adrenal function along with the hyperkinetic syndrome. MAH was characterized by dramatic discrepancy between the stroke and cardiac indices and specific peripheral resistance. Nephrosclerosis whose extent varied, attaining maximum in patients with associated essential hypertension and renal failure and in autopsy material, in addition to severe lesions of the renal vessels appeared to be the common feature of all morphological alterations. Plasmic impregnation and fibrinoid necrosis of the arterioles were not detectable in all the patients, being of focal character. The same alterations were identified in the patients during exacerbation of glomerulonephritis and in the absence of MAH. The data obtained point to the nonuniformity of MAH. Four clinicomorphological variants of MAH are suggested.

Aldosterone↗

PubMed1990

[The results of the surgical treatment of patients with vasorenal hypertension complicated by chronic kidney failure].

Treatment results were studied in 45 patients with vasorenal hypertension complicated by chronic renal in failure after surgical treatment. Transarterial endarterectomy, roentgen endovascular dilatation of the renal arteries, splenorenal arterial anastomosis, renal autotransplantation were used. A hypotensive effect followed in 21 (46.7%), function improvement in 29 (64.4%). Causes of failures: nephrosclerosis due to prolonged hypertension, concomitant diseases of the upper urinary tract, technical complications of the operation.

Adult↗

PubMed1985

Hemodynamic and cardiac adaptation in essential hypertension. Consequences for therapy.

In so-called essential hypertension, at least three different subsets of pathophysiologic findings can be identified: mild hypertension in nonobese juvenile subjects characterized by elevated cardiac output, normal peripheral resistance, increased sympathetic activity as measured by norepinephrine and plasma renin activity; hypertension in the elderly with a low cardiac output, often with left ventricular hypertrophy, elevated total peripheral resistance, nephrosclerosis contracted intravascular volume, and low plasma renin activity; and obese hypertensive patients with a high cardiac output, expanded intravascular volume, and a normal total peripheral resistance. Although there is often an overlap among these three entities, antihypertensive treatment can easily be adapted accordingly. A beta-adrenoreceptor blocker is the step-one drug to be used in mild hypertension with an elevated cardiac output. The drug's negative inotropic and chronotropic properties will bring the elevated cardiac output and heart rate back to normal. In the elderly hypertensive patient, an arteriolar and venous vasodilator, such as an antiadrenergic agent, slow channel calcium blocker, or a converting enzyme inhibitor, will lower total peripheral resistance and unburden the left ventricle. In the obese patient and also in most black subjects, the first-step antihypertensive agent remains a thiazide diuretic. Labetalol, an agent with both beta- and alpha-adrenoreceptor properties, shows promise for the treatment of hypertension in the young as well as in the older patient. It seems to be the agent of choice in patients with established essential hypertension who are concomitantly suffering from coronary artery disease.

Adaptation, Physiological↗

PubMedDate not supplied

Antiplatelet drugs or dicoumarol: what is the most effective prophylaxis in occlusive arterial disease?

Arterial thromboses lead to disturbances of vital function: myocardial infarction, ischemic cerebral infarction, disorders of peripheral blood flow, nephrosclerosis. Prophylaxis of thrombosis is still an unsolved problem, since diseases caused by thrombosis remain the first cause of death, at least in Western countries. After describing the pathomorphological and pathobiochemical findings, a survey of the literature on prophylaxis of occlusive arterial diseases is presented and the difference between anticoagulants and aggregation inhibitors is pointed out.

Arterial Occlusive Diseases↗

PubMed1989

Lisinopril in the treatment of hypertension.

Established essential hypertension is characterised haemodynamically by a normal cardiac output and elevated total peripheral resistance. As hypertensive cardiovascular disease progresses, and the patient grows older, cardiac output falls and total peripheral resistance is further elevated. The activity of the renin-angiotensin-aldosterone (RAA) system declines throughout life and reaches its lowest levels in the elderly, unless there is congestive heart failure. In long-standing hypertension, target organ disease such as left ventricular hypertrophy, nephrosclerosis and cerebrovascular damage is commonly observed. Rational antihypertensive therapy should therefore aim to lower total peripheral resistance, spare cardiac output, and maintain or improve blood flow to target organs. ACE inhibitors lower arterial pressure by decreasing total peripheral resistance, they maintain or improve cardiac contractility, promote regression of left ventricular hypertrophy, and increase renal blood flow. Lisinopril is a novel ACE inhibitor that does not contain a sulphydryl group. It is not a prodrug and thus does not require bioactivation by the liver. Lisinopril has a long duration of action, allowing it to be used as a single daily dose in the treatment of hypertension. Preliminary studies from our laboratory indicate that lisinopril reduces cardiac output and preload to the left ventricle. Lisinopril also reduces left ventricular hypertrophy and lowers renal vascular resistance, thereby increasing renal blood flow. In patients with mild to moderate hypertension, lisinopril is more effective than hydrochlorothiazide in reducing both systolic and diastolic blood pressure, and is at least as effective as atenolol or metoprolol in reducing diastolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin-Converting Enzyme Inhibitors↗

PubMed1989

Quantitative spectral analysis of carotid Doppler signal: evaluation as a method for measurement of drug effects.

Hemodynamic theories of atherogenesis suggest that the endothelial injury that initiates the process, as well as complications such as dissection and embolism, may be caused by arterial flow disturbances. Although treatment of high blood pressure prevents arteriolar complications such as brain haemorrhage and nephrosclerosis, little progress has been made in prevention of atherosclerotic events such as myocardial infarction. It is therefore desirable to develop methods for measuring the effects of antihypertensive drugs on the occurrence of such flow disturbances. We have evaluated quantitative spectral analysis of carotid Doppler signals in normals and in patients with carotid stenosis, in crossover studies of metoprolol vs placebo. Twenty healthy volunteers and 20 patients with carotid stenosis were treated in two double-blind placebo-controlled complete crossover studies, in which each subject took metoprolol 100 mg per os, and matching placebo, 1 hr before carotid scanning. In normals, peak frequency, mean frequency, and window index (WI) were measured at each of 2 sites in the left common, external and internal carotid arteries. Spectral broadening index (SBI), the ratio (peak-mean)/mean, was computed for comparison with window index (WI), the ratio of the area under the first 100 msec of the 25th percentile velocity curve to the area under the 75th percentile curve. Peak frequency, SBI and WI measure the extent of disturbance of arterial flow patterns, i.e. the extent to which flow has become non-laminar. Heart rate was reduced significantly by metoprolol, and in the external carotid artery, metoprolol significantly reduced both peak and mean frequency. Window index was not significantly changed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

[A radionuclide study of the renal filtration fraction in nephrogenic hypertension].

The effective renal plasma flow (ERPF), the rate of glomerular filtration and filtration fraction were investigated in 48 patients with nephrogenic hypertension (NH) using the method of dynamic renoscintigraphy with a double label (131I-hippuran and 99mTc-DTPA). The proposed method of noninvasive combined assessment of renal function was shown to be simple to perform and permitted the determination of a degree of involvement of the glomerular and tubular apparatus of the kidneys in NH. The comparison of renoscintigraphic and histomorphological results made it possible to determine renoscintigraphic criteria of glomerulo- and nephrosclerosis.

Adult↗

PubMed1989

Renal protection with calcium antagonism in essential hypertension.

The natural history of uncontrolled essential hypertension, with respect to renal function, is characterized by a progressive rise in renal vascular resistance, a progressive fall in effective renal plasma flow, and a progressive fall in glomerular filtration rate. Sustained effective antihypertensive therapy may reverse this pathophysiological sequence, preventing the development of arteriolar nephrosclerosis. It is unknown whether such a therapeutic benefit is a nonspecific response to controlling systemic hypertension, or is dependent on controlling both systemic and glomerular hypertension. Recent experimental evidence indicates that the control of systemic blood pressure may not necessarily be associated with control of glomerular capillary hypertension. The renal effects of calcium antagonists in essential hypertensive patients are only now being characterized. We have demonstrated that diltiazem, amlodipine, and nifedipine monotherapies enhance glomerular filtration rate and effective renal plasma flow, and lower renal vascular resistance. Although calcium antagonists attenuate the intrarenal effects of norepinephrine and angiotensin II, the precise mechanism(s) by which these drugs reverse the functional renal abnormalities in the essential hypertensive state, and by which they may attenuate the progression of hypertensive renal disease, are unknown. It is our hypothesis that renal protection requires normalization of both systemic and glomerular capillary pressure. Calcium antagonists have the ability to control systemic hypertension. If they can be demonstrated experimentally to reduce both pre- and post-glomerular capillary resistances (i.e. maintain a normal glomerular capillary pressure), they can be expected to provide long-term renal protection.

Calcium Channel Blockers↗

PubMed1989

[Dysplastic bases of the development of kidney diseases in childhood].

Altogether 412 children aged 1 to 15 years with chronic nephropathies of various etiology were examined. Methods of clinical morphology were applied. It is marked that in 42 percent of cases the development of glomerular and interstitial nephropathies was caused by foregoing disorders in the formation of the renal structure, chiefly at the tissue and cell levels. It is assumed that the majority of those disorders are multifactorial in nature. Alterations in cell membranes and in supramembraneous biopolymeric layers were also seen, being associated with the definite clinical symptomatology. It is stressed that of paramount importance is the design of the methods of stimulating therapy for correction of renal developmental abnormalities with a decrease of the risk of immunopathologic responses, chronic inflammation and nephrosclerosis.

Adolescent↗

PubMed1989

Assessment of progression of chronic renal failure--using reciprocal of serum creatinine.

Twenty-seven patients with chronic renal failure (CRF) were studied over a period of 6 to 57 months. The mean serum creatinine (Scr.) was 4 mg/dl. All patients were started on conservative therapy. The rate of progression of renal failure was assessed by least square linear regression analysis using reciprocal of Scr. (1/Scr.) versus time plots. Group I (13 patients) showed steady progression to end-stage renal failure (mean slope 0.013328). 7 of 13 patients had chronic glomerulonephritis. 11 had nephrotic proteinuria. In group II (14 patients), the regression line remained static indicating arrest of progression of renal disease (mean slope 0.0087858). 6 of 14 had nephrosclerosis. 3 had nephrotic proteinuria. We conclude that (1) assessment of progression of CRF by linear regression analysis of 1/Scr. vs time is a useful method. (2) persistent nephrotic proteinuria is an adverse longterm risk factor. (3) conservative therapy has a definite role in the management of CRF.

Adolescent↗

PubMed1989

[Disorders of fluid and electrolyte metabolism in elderly diabetics].

Disorders of fluid and electrolyte metabolism in elderly diabetics were studied. High frequency of hyperkalemia (20.8%), hypomagnesemia (14.6%), hypocalcemia (13.7%), hyperphosphatemia (8.6%), hyponatremia (8.1%) and hyperchloremia (7.2%) was observed among 332 elderly diabetics. Furthermore, hyperkalemia, hyperphosphatemia, hyponatremia, hyperchloremia, hypercalcemia and hypermagnesemia were more frequent in diabetics with renal insufficiency (serum Cr greater than or equal to 1.5 mg/dl) than in diabetics with normal renal function (serum Cr less than or equal to 1.4 mg/dl). In addition, statistically significant negative correlation were observed between plasma glucose levels and serum levels of sodium and chloride in diabetics with normal renal function. These results clearly demonstrated that the most important causal factor of electrolyte disorders in elderly diabetics might be the renal dysfunction due to diabetic nephropathy and/or nephrosclerosis. Moreover, glucose intolerance is also one of the causal factors for hyponatremia and hypochloremia. Disorders of fluid and electrolyte metabolism were manifest in 31 diabetic patients with hyperosmolar non-ketotic coma. The frequency of patients with abnormally elevated serum levels of sodium, potassium and chloride, and patients with abnormally lowered serum levels of calcium was high in this morbid state. Water and sodium deficit, examined in 11 cases of hyperosmolar non-ketotic coma, was 4780 +/- 2100 ml (107 +/- 43 ml/kg body weight) and 290 +/- 170 mEq (6.8 +/- 4.2 mEq/kg body weight), respectively. However, no significant deficit of potassium was observed in the patients. Statistically significant positive correlations between water deficit and serum Cr levels and with serum effective osmolarity were observed. However, there were no significant correlations between water deficit and plasma glucose levels, serum sodium levels and serum osmolarity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1988

[Enzymuria following administration of contrast media in hypertensive rats].

Renal complications may occur in risk patients with pre-existing kidney damage if x-ray contrast media are administered. Nothing is known of the exact mechanisms of these reactions. We examined in rats with long-term renovascular hypertension and resulting nephrosclerosis the low osmolar contrast media ioxaglate, iohexol and iopamidol in respect of their renal tolerance compared with an osmotically equivalent mannite solution. Under the conditions of intravenous pyelography, we observed directly after the administration of all substances (3.5 mg/kg body weight) an enhanced enzymuria of gamma-glutamyl transpeptidase and N-acetyl-beta-D-glucosaminidase. The loss of enzyme is mainly due to the osmotic effect of the preparations. The nonionic contrast media iohexol and iopamidol produce a slighter enzymuria than the ionic ioxaglate.

Acetylglucosaminidase↗

PubMed1985

[Renovascular hypertension--diagnosis and therapeutic possibilities].

The causes of renal vascular hypertension are outlined. These are guided by the influence on the renin-angiotensin mechanism. The so-called essential hypertension is not infrequently caused by an early nephrosclerosis, which can be diagnosed very early through electrone microscopy. Renal artery stenosis, caused by fibrodysplasia or arteriosclerosis represents a special case of renal vascular hypertension which can be treated effectively by balloon catheter dilatation. The results in 240 patients are presented where these therapeutic principles were applied.

Angioplasty, Balloon↗

PubMed1987

Effects of atrial natriuretic factor in rats with renal insufficiency.

To test the effect of exogenous atrial natriuretic factor (ANF) on the kidney function of rats with chronic renal insufficiency, we examined the responses to bolus infusions of atriopeptin III in two models of renal insufficiency, namely, nephrosclerosis and glomerulonephritis. Hypertensive Dahl S rats receiving a high (8%) NaCl diet for 12 weeks, and rats with anti-glomerular basement membrane nephritis, both of which had glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) less than half those of respective control rats, exhibited similar relative increases In GFR and ERPF in response to atriopeptin III as did controls. Natriuresis, diuresis, and decreased blood pressure were as prominent in rats with either form of renal disease as in control rats. Rats receiving high NaCl intake, irrespective of renal function, had relatively exaggerated responses compared with rats receiving a normal NaCl diet. We conclude that rats with chronic renal insufficiency of diverse causes respond briskly to ANF despite presumed hyperperfused and hyperfiltering nephrons. Thus, diseased kidneys exhibit substantial renal functional "reserve." The renal response to ANF appears to be influenced by NaCl intake in both normal animals and those with renal insufficiency.

Animals↗

PubMed1988

Cutaneous malakoplakia. Report of a case.

A case of cutaneous malakoplakia in a 44-year-old women under immunosuppressive therapy after renal transplantation for nephrosclerosis is reported. A nodular lesion with inflammatory signs appeared on her right buttock. Histopathology showed a dermal infiltrate with histiocytes containing Michaelis-Gutmann bodies. Electron microscopy showed Michaelis-Gutmann bodies with concentric laminar structure ('target' appearance). Tissue culture revealed Escherichia coli growth. Lesions recurred on surrounding skin and left buttock after excision. Clofazimine treatment resulted in total remission.

Adult↗

PubMed1988

[Renal amyloidosis. An echographic study of 7 cases].

Seven patients suffering from renal amyloidosis (2 primitive and 5 secondary) underwent US examination. The results show a strict correlation between US findings and the pathologic changes produced by this condition. US proves to be especially useful in the early stages of the disease: its results, together with the clinical data, may in fact be highly suggestive of the correct diagnosis. On the contrary, in the late stages of renal amyloidosis, when pathologic changes lead to progressive nephrosclerosis, US findings appear aspecific, since they are undistinguishable from the patterns observed in other renal medical disorders.

Amyloidosis↗

PubMed1988

Renal pathology and proteinuria determine progression in untreated mild/moderate chronic renal failure.

The progression of renal failure was analyzed in 108 patients with mild to moderate renal impairment, none of whom had received any form of dietary protein, phosphate restriction or immunosuppressive treatment. The reciprocal of plasma creatinine was plotted against time using a minimum of six plasma creatinine values taken over at least six months (mean 13 values over 41 months). Plots indicated there was linear deterioration in 70 patients, non-linear deterioration in 15 and stable renal function in 24. Progressive renal failure was common in patients with glomerulonephritis, diabetic nephropathy, chronic pyelonephritis and polycystic kidney disease. Most patients with hypertensive nephrosclerosis, analgesic nephropathy and renal impairment following acute renal failure were stable. Among those with progressive impairment the mean rates of deterioration were significantly faster for patients with glomerulonephritis and diabetic nephropathy compared to those with chronic pyelonephritis, polycystic kidney disease and undiagnosed renal disease (p less than 0.01). Hence the underlying renal pathological changes appear to be important in determining progression of renal failure and also the subsequent rate of deterioration. For those with linear progression of renal failure there was a significant correlation between 24-h urinary protein excretion and the rate of deterioration. This relationship held for glomerulonephritis and chronic pyelonephritis as separate diagnostic groups only. Proteinuria, therefore, may be a useful prognostic index for the rate of progression of established renal failure. Calcium phosphate product correlated poorly with the rate of deterioration. We were unable to demonstrate a relationship between spontaneous protein intake and deterioration of renal function. However, patients prescribed high protein diets were not included in dietary analysis and we cannot, therefore, exclude the possibility that a high dietary protein intake may accelerate renal failure. Similarly we were unable to show a significant relationship between blood pressure and progression of renal failure although there were weak correlations between mean arterial pressure and rate of deterioration for chronic pyelonephritis and glomerulonephritis.

Blood Pressure↗