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Sample records for experimental renal hypertension

  1. The renal transcriptome in experimental hypertension

    NARCIS (Netherlands)

    Wesseling, S.

    2007-01-01

    The renal transcriptome in experimental hypertension The kidneys importantly determine blood pressure. Kidney dysfunction can result in hypertension, which in turn leads to renal damage. In primary hypertension the cause is unknown. The condition is polygenic, however, which genetic defects cause

  2. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  3. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  4. Renal denervation for resistant hypertension.

    Science.gov (United States)

    Almeida, Manuel de Sousa; Gonçalves, Pedro de Araújo; Oliveira, Eduardo Infante de; Carvalho, Henrique Cyrne de

    2015-02-01

    There is a marked contrast between the high prevalence of hypertension and the low rates of adequate control. A subset of patients with suboptimal blood pressure control have drug-resistant hypertension, in the pathophysiology of which chronic sympathetic hyperactivation is significantly involved. Sympathetic renal denervation has recently emerged as a device-based treatment for resistant hypertension. In this review, the pathophysiological mechanisms linking the sympathetic nervous system and cardiovascular disease are reviewed, focusing on resistant hypertension and the role of sympathetic renal denervation. An update on experimental and clinical results is provided, along with potential future indications for this device-based technique in other cardiovascular diseases. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  5. Renal inflammation, autoimmunity and salt-sensitive hypertension

    Science.gov (United States)

    Rodríguez-Iturbe, Bernardo; Franco, Martha; Tapia, Edilia; Quiroz, Yasmir; Johnson, Richard J

    2011-01-01

    This article reviews the role of immune competent cells infiltrating the kidney and their association with oxidative stress and renal angiotensin activity in the development of salt-sensitive hypertension.We discuss the alteration of the pressure-natriuresis relationship resulting from renal inflammation and its improvement resulting from immunosuppressive treatment.The potential role of T cell-driven reactivity in sustaining the renal inflammation is examined in the light of accumulating evidence of autoimmune mechanisms in experimental and clinical hypertension. PMID:21251049

  6. RENAL ARTERIAL HYPERTENSION IN CHILDREN AND ADOLESCENTS: CAUSES, CLASSIFICATION, DIAGNOSIS

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    N. D. Savenkova

    2017-01-01

    Full Text Available Classification of blood pressure in children and adolescents, features of renovascular hypertension and renal parenchymal hypertension in children and adolescents. Mid-aortic syndrome is characterized by the narroving of the abdominal aorta and bilateral renal artery stenosis. In the article are discussed diagnosis renal arterial hypertension and the defeat of target-organs in children and adolescents. 

  7. Hypertension in Renal Transplantation: Saudi Arabian Experience

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    Souqiyyeh Muhammad

    1999-01-01

    Full Text Available To evaluate the prevalence, etiologic factors and therapy of hypertension in actively followed up transplant population in Saudi Arabia; we retrospectively reviewed the records of the active renal transplant patients at two large transplant centers in Riyadh and Jeddah in Saudi Arabia. These subjects were transplanted between January 1979 and November 1998. The patients were grouped according to the measurement of blood pressure; group 1 (considered normo-tensive: blood pressure below 140/90 mmHg, group2: blood pressure between 140-159/90-99, group 3: blood pressure 160-179/100-109 group 4: equal to or above 180/110. There were 1115 patients′ records included in the study. The mean duration of transplantation was 66.9 ± 50.1 months. According to the level of measured blood pressure, there were 641 (57.5% patients in the normotensive group (group 1, 404 (36.3% patients in the mildly hypertensive group (group 2 64 (5.7% patients in the moderately severe hypertension group (group 3 and only six (0.5% patients in the severe hypertension group (group 4. The estimated prevalence of hypertension in this study was almost 85%. We found no significant difference in the prevalence of hypertension in terms of gender, year of transplantation, duration of transplantation, type of donor, number of previous transplants, diagnosis of renal artery stenosis, etiology of kidney disease, diagnosis of diabetes after transplantation, diagnosis of cerebrovascular accidents, or mean dose of prednisolone and cyclosporine. There was a statistically significant association between increased level of blood pressure and old age (above 50 years, original disease associated with hypertension, history of hypertension on dialysis, acute rejection (once or more, presence of protienuria (more than 0.3 mg/day, abnormality of ECG, or serum creatinine above 300 µmol/L. We conclude that hypertension is highly prevalent in the renal transplant population in Saudi Arabia. Risk

  8. Brazilian red propolis attenuates hypertension and renal damage in 5/6 renal ablation model.

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    Flávio Teles

    Full Text Available The pathogenic role of inflammation and oxidative stress in chronic kidney disease (CKD is well known. Anti-inflammatories and antioxidant drugs has demonstrated significant renoprotection in experimental nephropathies. Moreover, the inclusion of natural antioxidants derived from food and herbal extracts (such as polyphenols, curcumin and lycopene as an adjuvant therapy for slowing CKD progression has been largely tested. Brazilian propolis is a honeybee product, whose anti-inflammatory, antimicrobial and antioxidant effects have been widely shown in models of sepsis, cancer, skin irritation and liver fibrosis. Furthermore, previous studies demonstrated that this compound promotes vasodilation and reduces hypertension. However, potential renoprotective effects of propolis in CKD have never been investigated. The aim of this study was to evaluate the effects of a subtype of Brazilian propolis, the Red Propolis (RP, in the 5/6 renal ablation model (Nx. Adult male Wistar rats underwent Nx and were divided into untreated (Nx and RP-treated (Nx+RP groups, after 30 days of surgery; when rats already exhibited marked hypertension and proteinuria. Animals were observed for 90 days from the surgery day, when Nx+RP group showed significant reduction of hypertension, proteinuria, serum creatinine retention, glomerulosclerosis, renal macrophage infiltration and oxidative stress, compared to age-matched untreated Nx rats, which worsened progressively over time. In conclusion, RP treatment attenuated hypertension and structural renal damage in Nx model. Reduction of renal inflammation and oxidative stress could be a plausible mechanism to explain this renoprotection.

  9. Anomalous renal artery is potential cause of resistant hypertension ...

    African Journals Online (AJOL)

    Background: Drug-resistant hypertension can be attributable to secondary hypertension and other causes. Anomalous renal artery is uncommon but can be a potential cause of resistant hypertension. Case Report: We highlight the challenges in management of resistant hypertension and describe its unusual association ...

  10. Vascular Remodeling in Experimental Hypertension

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    Norma R. Risler

    2005-01-01

    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  11. Renal oxidative stress, oxygenation, and hypertension.

    Science.gov (United States)

    Palm, Fredrik; Nordquist, Lina

    2011-11-01

    Hypertension is closely associated with progressive kidney dysfunction, manifested as glomerulosclerosis, interstitial fibrosis, proteinuria, and eventually declining glomerular filtration. The postulated mechanism for development of glomerulosclerosis is barotrauma caused by increased capillary pressure, but the reason for development of interstitial fibrosis and the subsequently reduced kidney function is less clear. However, it has been hypothesized that tissue hypoxia induces fibrogenesis and progressive renal failure. This is very interesting, since recent reports highlight several different mechanisms resulting in altered oxygen handling and availability in the hypertensive kidney. Such mechanisms include decreased renal blood flow due to increased vascular tone induced by ANG II that limits oxygen delivery and increases oxidative stress, resulting in increased mitochondrial oxygen usage, increased oxygen usage for tubular electrolyte transport, and shunting of oxygen from arterial to venous blood in preglomerular vessels. It has been shown in several studies that interventions to prevent oxidative stress and to restore kidney tissue oxygenation prevent progression of kidney dysfunction. Furthermore, inhibition of ANG II activity, by either blocking ANG II type 1 receptors or angiotensin-converting enzyme, or by preventing oxidative stress by administration of antioxidants also results in improved blood pressure control. Therefore, it seems likely that tissue hypoxia in the hypertensive kidney contributes to progression of kidney damage, and perhaps also persistence the high blood pressure.

  12. Different regulation of miR-29a-3p in glomeruli and tubules in an experimental model of angiotensin II-dependent hypertension: potential role in renal fibrosis.

    Science.gov (United States)

    Castoldi, Giovanna; di Gioia, Cira; Giollo, Fabrizio; Carletti, Raffaella; Bombardi, Camila; Antoniotti, Marco; Roma, Francesca; Zerbini, Gianpaolo; Stella, Andrea

    2016-03-01

    The aim of this study was to evaluate the role of the angiotensin II (Ang II) induced-differential miRNA expression in renal glomerular and tubulo-interstitial fibrosis in an experimental model of Ang II-dependent hypertension. To clarify this issue, Sprague Dawley rats were treated with Ang II (200 ng/kg per minute, n = 15) or physiological saline (n = 14) for 4 weeks. Systolic blood pressure and albuminuria were measured every 2 weeks. At the end of the experimental period, renal glomerular and tubulo-interstitial fibrosis was evaluated by histomorphometric analysis, after Sirius-Red and Masson's trichrome staining. Ang II increased systolic blood pressure (P renal tubules and up-regulated in glomeruli. Real-time polymerase chain reaction (PCR) experiments confirmed in Ang II-treated rats a down-regulation of miR-29a-3p in tubules (P renal tubules is different from the one exerted in the glomeruli and that miR-29a-3p targets MMP-2. These results suggest that the development of renal fibrosis at glomerular and tubulo-interstitial level depends on different molecular mechanisms. © 2016 John Wiley & Sons Australia, Ltd.

  13. Hypertensive disease and renal hypertensions: renal structural and functional studies by using dynamic computed tomography

    International Nuclear Information System (INIS)

    Arabidze, G.G.; Pogrebnaya, G.N.; Todua, F.I.; Sokolova, R.I.; Kozdoba, O.A.

    1989-01-01

    Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cartical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney

  14. Hypertensive Cardiovascular and Renal Disease and Target Organ Damage: Lessons from Animal Models

    Science.gov (United States)

    Susic, Dinko; Frohlich, Edward D.

    2011-01-01

    This brief review discusses some aspects of hypertensive damage to the kidneys and cardiovascular system. A comparison of renal and cardiac manifestations of hypertensive disease between results of clinical and experimental studies was made, with a major focus on the possible role of salt and the renin-angiotensin system (RAS) in inducing target organ damage. Thus, some degree of renal impairment is often present in patients with essential hypertension, varying from microalbuminuria to end-stage renal disease, whereas in rats with spontaneous hypertension only slight renal damage is seen in old rats with little evidence of renal failure. Since renal damage in hypertensive rats is induced when they are exposed to increased salt intake, we suggested that salt may also account for kidney injury in hypertensive patients. Similarly, cardiac damage is aggravated in hypertensive human beings and rats when given salt excess. We further presented evidence that the RAS may mediate adverse cardiac and renal effects of excessive salt intake. Finally, we also discussed some aspects of the cardiovascular physiology in the giraffe, the only mammal that in comparison with the human being has extremely high pressure at the level of the heart and kidneys but no target organ damage. PMID:22258536

  15. Hyponatremic Hypertensive Syndrome in an Obese Man with Renal Ischemia

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    Saeed Khawer

    2006-01-01

    Full Text Available Renovascular hypertension occasionally manifests as an electrolyte disorder. The combination of hyponatremia and renovascular hypertension is known as hyponatremic-hypertensive syndrome. This syndrome was initially reported in children. Here, we describe a 45 year-old Saudi man who was admitted to the hospital with generalized body weakness and inability to walk. He was confused and was noted to have severe hypertension and very low serum sodium and potassium. The patient was recently started on captopril for blood pressure control, which was discontinued because of deterioration of renal function. Color Doppler renal ultrasound, and magnetic resonance angiography confirmed the diagnosis of renal artery stenosis.

  16. Renal denervation and hypertension - The need to investigate unintended effects and neural control of the human kidney.

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    Grisk, Olaf

    2017-05-01

    Increased renal sympathetic nerve activity (RSNA) is present in human and experimental forms of arterial hypertension. Experimental denervation studies showed that renal nerves contribute to the development of hypertension. Clinical trials provided equivocal results on the antihypertensive efficacy of renal denervation in patients spurring discussions on technical aspects of renal denervation and further research on the role of renal nerves for the regulation of kidney function as well as the pathophysiology of hypertension. This review summarizes recent findings on adrenoceptor expression and function in the human kidney, adrenoceptor-dependent regulation of sodium chloride transport in the distal nephron, experimental data on chronic RSNA and the development of high arterial pressure and consequences of renal denervation that may limit its antihypertensive efficacy. Future research needs to reduce the gap between our knowledge on neural control of renal function in animals vs. humans to facilitate translation of experimental animal data to humans. More experimental studies on the temporal relationship between RSNA and arterial pressure in the chronic setting are needed to better define the pathogenetic role of heightened RSNA in different forms of arterial hypertension in order to improve the rational basis for renal denervation in antihypertensive therapy. Finally, research on unintended consequences of renal denervation including but not limited to reinnervation and denervation supersensitivity needs to be intensified to further assess the potential of renal denervation to slow the progression of renal disease and hypertension. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Anti-Renal Fibrotic Effect of Exercise Training in Hypertension

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    Chiu-Ching Huang

    2018-02-01

    Full Text Available The purpose of this study was to evaluate the effects of exercise training on renal fibrosis in hypertensive rats. Masson’s trichrome staining and Western blotting were performed on the excised renal cortex from sixteen male spontaneously hypertensive rats (SHR, which were randomly divided into either a sedentary hypertensive group (SHR or exercise hypertensive group (SHR-EX, running on an exercise treadmill for 60 min/day, 5 sessions/week, for 12 weeks, and from eight male Wistar-Kyoto rats which served as a sedentary normotensive group (WKY. The systolic blood pressure (SBP and renal fibrosis in hypertensive rats improved after exercise training. The inflammatory-related protein levels of interleukin-6 (IL-6 and cyclooxygenase-2 (COX-2, as well as the fibrotic-related protein levels of transforming growth factor-beta (TGF-β, phospho-Smad2/3 (p-Smad2/3, connective tissue growth factor (CTGF, matrix metalloproteinase-9 (MMP-9, and matrix metalloproteinase-2 (MMP-2 were decreased in the SHR-EX group when compared with the SHR group. Exercise training suppressed the hypertension-induced renal cortical inflammatory and fibrotic pathways in hypertensive rat models. These findings might indicate a new therapeutic effect for exercise training to prevent renal fibrosis in hypertensive nephropathy.

  18. Hyponatremic Hypertensive Syndrome in an Obese man with Renal Ischemia

    International Nuclear Information System (INIS)

    Saeed, K.

    2006-01-01

    Renovascular hypertension occasionally manifests as an electrolyte disorder. The combination of hyponetrimia and renovascular hypertension occasionally manifests as an electrolyte disorder. The combination of hyponatremia and renovascular hypertension is known as hyponatremic-hypertensive syndrome. This syndrome was initially reported in children. Here we describe a 45 year-old Saudi man who was admitted to the hospital with generalized body weakness and inability to walk. He was confused and was noted to have severe hypertension and very low serum sodium and potassium. The patient was recently started on captopril for blood pressure control, which was discontinued because of deterioration renal function. Color Doppler renal ultrasound, and magnetic resonance angiography confirmed the diagnosis of renal artery stenosis. (author)

  19. Review Article its renal Africans hypertension and in black South ...

    African Journals Online (AJOL)

    1989-08-19

    Aug 19, 1989 ... ·of 65 parients in whom renal histological examination was carried our. In parients in whom renal histological examinarion was not carried out malignant ... figures which show an 80% actuarial graft survival at 30 months of 1072 patients of all race groups who received transplants without hypertension ...

  20. Renal Tissue Oxygenation in Essential Hypertension and Chronic Kidney Disease

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    Menno Pruijm

    2013-01-01

    Full Text Available Animal studies suggest that renal tissue hypoxia plays an important role in the development of renal damage in hypertension and renal diseases, yet human data were scarce due to the lack of noninvasive methods. Over the last decade, blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI, detecting deoxyhemoglobin in hypoxic renal tissue, has become a powerful tool to assess kidney oxygenation noninvasively in humans. This paper provides an overview of BOLD-MRI studies performed in patients suffering from essential hypertension or chronic kidney disease (CKD. In line with animal studies, acute changes in cortical and medullary oxygenation have been observed after the administration of medication (furosemide, blockers of the renin-angiotensin system or alterations in sodium intake in these patient groups, underlining the important role of renal sodium handling in kidney oxygenation. In contrast, no BOLD-MRI studies have convincingly demonstrated that renal oxygenation is chronically reduced in essential hypertension or in CKD or chronically altered after long-term medication intake. More studies are required to clarify this discrepancy and to further unravel the role of renal oxygenation in the development and progression of essential hypertension and CKD in humans.

  1. The dark side of the kidney in cardio-renal syndrome: renal venous hypertension and congestive kidney failure.

    Science.gov (United States)

    Di Nicolò, Pierpaolo

    2018-03-01

    Renal involvement in some forms of acute or chronic diseases, such as heart failure or sepsis, presents with a complex pathophysiological basis that is not always clearly distinguishable. In these clinical settings, kidney failure is traditionally and almost exclusively attributed to renal hypoperfusion and it is commonly accepted that causal elements are pre-renal, such as a reduction in the ejection fraction or absolute or relative hypovolemia acting directly on oxygen transport mechanisms and renal autoregulation systems, causing a reduction of glomerular filtration rate. Nevertheless, the concept emerging from accumulating clinical and experimental evidence is that in complex clinical pictures, kidney failure is strongly linked to the hemodynamic alterations occurring in the renal venous micro and macrocirculation. Accordingly, the transmission of the increased venous pressure to the renal venous compartment and the consequent increasing renal afterload has a pivotal role in determining and sustaining the kidney damage. The aim of this review was to clarify the physiopathological aspects of the link between worsening renal function and renal venous hypertension, analyzing the prognostic and therapeutic implications of the so-called congestive kidney failure in cardio-renal syndrome and in other clinical contexts of its possible onset.

  2. OBESITY-INDUCED HYPERTENSION: INTERACTION OF NEUROHUMORAL AND RENAL MECHANISMS

    Science.gov (United States)

    Hall, John E.; do Carmo, Jussara M.; da Silva, Alexandre A.; Wang, Zhen; Hall, Michael E.

    2015-01-01

    Excess weight gain, especially when associated with increased visceral adiposity, is a major cause of hypertension, accounting for 65–75% of the risk for human primary (essential) hypertension. Increased renal tubular sodium reabsorption impairs pressure natriuresis and plays an important role in initiating obesity hypertension. The mediators of abnormal kidney function and increased blood pressure during development of obesity hypertension include 1) physical compression of the kidneys by fat in and around the kidneys, 2) activation of the renin-angiotensin-aldosterone system (RAAS), and 3) increased sympathetic nervous system (SNS) activity. Activation of the RAAS system is likely due, in part, to renal compression as well as SNS activation. However, obesity also causes mineralocorticoid receptor activation independent of aldosterone or angiotensin II. The mechanisms for SNS activation in obesity have not been fully elucidated but appear to require leptin and activation of the brain melanocortin system. With prolonged obesity and development of target organ injury, especially renal injury, obesity-associated hypertension becomes more difficult to control, often requiring multiple antihypertensive drugs and treatment of other risk factors, including dyslipidemia, insulin resistance and diabetes, and inflammation. Unless effective anti-obesity drugs are developed, the impact of obesity on hypertension and related cardiovascular, renal and metabolic disorders is likely to become even more important in the future as the prevalence of obesity continues to increase. PMID:25767285

  3. Impaired EphA4 signaling leads to congenital hydronephrosis, renal injury, and hypertension

    DEFF Research Database (Denmark)

    Sällström, Johan; Peuckert, Christiane; Gao, Xiang

    2013-01-01

    and renal injuries, similar to that of experimental hydronephrosis. Ultrasound and Doppler techniques were used to visualize renal impairment in the adult mice. Telemetric blood pressure measurements were performed in EphA4(gf/gf) mice and littermate controls (EphA4(+/+)) during normal (0.7% NaCl)- and high...... (4% NaCl)-sodium conditions. Renal excretion, renal plasma flow, and glomerular filtration were studied, and histology and morphology of the kidneys and ureters were performed. EphA4(gf/gf) mice developed variable degrees of hydronephrosis that correlated with their blood pressure level. In contrast...... to EphA4(+/+), the EphA4(gf/gf) mice displayed salt-sensitive hypertension, reduced urine concentrating ability, reduced renal plasma flow, and lower glomerular filtration rate. Kidneys from EphA4(gf/gf) mice showed increased renal injuries, as evidenced by fibrosis, inflammation, and glomerular...

  4. Invasive assessment of renal artery atherosclerotic disease and resistant hypertension before renal sympathetic denervation.

    Science.gov (United States)

    Ribichini, Flavio; Pighi, Michele; Zivelonghi, Carlo; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

    2013-01-01

    Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. The presence of a renal artery stenosis may be both a cause of secondary hypertension and a contraindication to RSD if a renal artery stent is implanted; therefore, the definition of the functional importance of a renal artery stenosis in a patient with refractory hypertension is crucial. We describe the imaging and functional intravascular assessment of an angiographically severe stenosis of the renal artery in a patient with severe refractory hypertension, by means of intravascular ultrasound (IVUS), and measurement of the translesional pressure gradient with a pressure wire. Pressure wire examination excluded any severity of the stenosis, and IVUS showed the presence of a dissected plaque that resolved spontaneously after 3 months of intensive medical therapy and high-dose statin. Subsequently the patient was treated with RSD, achieving a significant effect on blood pressure control. Intravascular imaging and functional assessment of renal artery anatomy in patients with atherosclerotic disease may prove particularly suited to patients with refractory hypertension and multilevel vascular disease who are considered for endovascular therapies, either renal artery stenting or RSD.

  5. Malignant hypertension in a patient with end of stage renal disease (esrd) treated by renal transplant

    International Nuclear Information System (INIS)

    Gondal, M.; Farook, K.; Moin, S.; Bano, Z.

    2007-01-01

    Control of hypertension is often a problem in the management of end stage renal disease (ESRD). Multiple modalities of treatment are required to prevent cardiovascular and cerebrovascular mortality and morbidity. These include fluid and salt restriction, multidrug regimes and dialysis. We report a case of young 25 years old patient, admitted with chronic renal failure, complicated by malignant and refractory hypertension, not responding to hemodialysis and antihypertensive agent. During stay in hospital, patient also had intracerebral hemorrhage, fits due to uncontrolled hypertension requiring ventilatory support followed. Renal transplant was considered to be the final therapeutic modality. After gradual recovery, a successful live-related renal transplant was performed. As soon as good graft was established, the blood pressure settled and 4 of the 5 antihypertensives were withdrawn. After 2 weeks, patient was discharged in a stable condition with a total stay of about 2 months. (author)

  6. Malignant hypertension and its renal complications in black South ...

    African Journals Online (AJOL)

    Acute partially reversible renal failure occurs in 20% of patients with malignant hypertension who require dialysis. This is an important subgroup, who may be recognised by their younger age, female preponderance and fulminant presentation. Short-term peritoneal dialysis and effective control of blood pressure will result in ...

  7. Sequential and functional renal scintiscanning in diabetic and hypertensive patients

    International Nuclear Information System (INIS)

    Wagner, M.

    1978-01-01

    47 diabetics (94 kidneys), 30 diabetics with concurrent hypertension (60 kidneys), and 23 hypertensives (46 kidneys) were examined by renal serial functional scintiscanning with 131 I-ortho-iodo-hippuric acid. For evaluation, camera nephrographs of the whole kidney, renal hemispheres, and renal cortex were used according to the technique of 'regions of interest', and the parameters of secretory value, maximum secretion, and elimination half-life were determined on this basis. With regard to the extent of hypertension, there are significant differences between all three groups for the elimination half-life; as far as the secretory value was concerned, there was a difference between the group with high hypertension and the two other groups. Significant differences in secretory value and elimination half-life were also observed in hypertensives with and without changes in the fundus of the eye. There was no noticeable difference between the three parameters in groups with and without albuminuria. (orig./AJ) 891 AJ/orig.- 892 MKO [de

  8. Hyponatremic hypertensive syndrome secondary to renal ischemia – Case report

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    Joana Cunha Oliveira

    2018-01-01

    Full Text Available Hyponatremic hypertensive syndrome (HHS is characterized by hypertensive crisis, and hyponatremia secondary to unilateral renal damage with glomerular and tubular dysfunction. Elevated plasma levels of renin in most cases suggest that the stimulation of renin release from the ischemic kidney plays an important pathophysiologic role. Activation of the renin-angiotensin system results in hypertension and causes secondary hyperfiltration, pressure diuresis and sodium loss from contralateral non-damaged kidney. An elevated renin level is a pathognomonic finding in HHS. Potassium deficiency from hyperaldosteronism may further stimulate renin secretion and intensify this vicious circle.We report a female term newborn, who presented with hypertensive crisis on the seventh day after traumatic birth. The first three days of life were uneventful. Initial treatment with captopril resulted in severe hypotension and hemodynamic instability. Lab work revealed hyponatremia, hypokalemia, and elevated peripheral renin activity and aldosterone levels. Complementary sonography and magnetic resonance confirmed right adrenal gland hematoma and several ischemic areas in the upper pole of the right kidney. The diagnosis of HHS secondary to renal ischemia was evoked.HHS is a rare condition in the neonatal period, though still under-recognized. In the neonatal and early infancy period, renovascular disease is the most common cause of secondary hypertension. In this case, there was no sign of vascular disease, the renin-angiotensin system was activated secondary to direct renal ischemia and infarction. The intense renin stimulation and pressure through the contralateral normal kidney results in high pressure natriuresis facilitating a severe volume-depleted state. Although the use of renin-angiotensin system inhibitors is the treatment of choice, it is imperative to re-establish hydration and renal perfusion before starting this antihypertensive medication. We aimed to

  9. Cardiac and renal damage in the elderly hypertensive

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    Jean Ribstein

    2002-03-01

    Full Text Available In the elderly patient with essential hypertension of long duration or de novo systolic hypertension, the prevalence of co-morbid conditions, be they apparent or not, the burden of associated diseases and the alteration in nutritional status and lifestyle, result in specific problems with regards to hypertension-related target organ damage. Accumulating data suggest that left ventricular (LV remodelling is a common finding in the nor-motensive elderly, and that LV hypertrophy (LVH will herald the development of heart failure in a fraction of patients with either systolic/diastolic or isolated systolic hypertension. Increased arterial stiffness, as well as impaired myocardial relaxation, reduced early diastolic filling and decreased ?-adrenergic responsiveness, contribute to the large prevalence of abnormalities in LV function in the elderly hypertensive. The response to exercise is clearly attenuated, and coronary heart disease, although highly prevalent, may be misdiagnosed because symptoms are altered. The elderly hypertensive is exquisitely sensitive to both volume depletion and excessive sodium intake, due to a marked sodium sensitivity of blood pressure (BP. A decline in renal blood flow and glomerular filtration rate (GFR is a common finding in the elderly. Although structural alterations attributed to age and hypertension may differ, hypertension is often looked upon as an accelerated form of ageing with regards to the heart and the kidney. Lifestyle modifications and initial monotherapy with a low-dose diuretic are warranted in the elderly hypertensive with no co-morbidity; a variety of specific approaches are considered when associated clinical conditions are present. Blockers of the renin-angiotensin system (RAS may be the preferred first-line agents in many patients with cardiac or renal damage.

  10. Renal denervation in moderate treatment-resistant hypertension.

    Science.gov (United States)

    Ott, Christian; Mahfoud, Felix; Schmid, Axel; Ditting, Tilmann; Sobotka, Paul A; Veelken, Roland; Spies, Aline; Ukena, Christian; Laufs, Ulrich; Uder, Michael; Böhm, Michael; Schmieder, Roland E

    2013-11-12

    This study sought to investigate the effect of renal denervation (RDN) in patients with treatment-resistant hypertension according to the established definition (Joint National Committee VII and European Society of Hypertension/European Society of Cardiology guidelines), that is, office blood pressure (BP) ≥140/90 mm Hg (with at least three antihypertensive drugs, including a diuretic, in adequate doses) and confirmed by 24-h ambulatory BP monitoring (ABPM). RDN emerged as an innovative interventional antihypertensive therapy. However, so far, only patients with severe hypertension (systolic BP ≥160 mm Hg or ≥150 mm Hg for patients with type 2 diabetes) have been investigated. In this study, there were 54 patients with moderate treatment-resistant hypertension (office BP ≥140/90 mm Hg and who underwent catheter-based RDN using the Symplicity catheter (Medtronic Inc., Mountain View, California). Patients were treated with 5.1 ± 1.4 antihypertensive drugs on average. Office BP was significantly reduced by 13/7 mm Hg 6 months after RDN (systolic: 151 ± 6 mm Hg vs. 138 ± 21 mm Hg, p who underwent ABPM 6 months after treatment, there was a reduction in average 24-h ABPM by 14/7 mm Hg (systolic: 150 ± 16 mm Hg vs. 136 ± 16 mm Hg, p hypertension. (Renal Denervation in Treatment Resistant Hypertension; NCT01687725). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  12. Characterization of renal hyperemia in portal hypertensive rats

    Energy Technology Data Exchange (ETDEWEB)

    Premen, A.J.; Banchs, V.; Go, V.L.W.; Benoit, J.N.; Granger, D.N.

    1986-03-01

    In anesthetized sham-operated control (C) and portal vein stenosed (PVS) rats, renal blood flow (RBF) was measured with radioactive microspheres on days 2, 4, 6, 8, and 10 following surgery. On day 2, only a small increase in RBF (19%) was produced in PVS versus C rats. However, by day 4, a significant increase in RBF (35%) was observed in PVS versus C animals. By day 6, the renal hyperemia in PVS rats reached a maximal value that was 42% higher than in C rats. Thereafter (on days 8 and 10), the renal hyperemia remained at the maximal value. In a separate group of 10-day PVS rats, glucagon antiserum failed to attenuate the 44% increase in RBF observed in PVS versus C rats. Radioimmunoassay of C and PVS plasma (10-day samples) revealed that vasoactive intestinal polypeptide, substance P, cholecystokinin/gastrin, neurotensin, pancreatic polypeptide, beta-endorphin, and peptide histidine-isoleucine amide are not elevated in arterial plasma of PVS rats. These data indicate that the renal hyperemia induced by chronic portal hypertension is manifested within 4 days after the hypertensive insult. Our studies also suggest that at least 9 blood-borne gastrointestinal peptides are not directly involved in the renal response to portal vein stenosis.

  13. Renal dynamic scintigraphy with captropil in systemic arterial hypertension diagnosis

    International Nuclear Information System (INIS)

    Cervo, Marco Antonio Cadorna; Amarante Junior, Jose Luiz de Medeiros; Souza, Ricardo Alberto Manhaes; Evangelista, Maria Gardenia

    1995-01-01

    Forty one patients, 15 male and 16 female presenting systemic arterial hypertension were submitted to Basal RDC and after being simulated by Captopril; the radiotracer used was 99 mTc-DTPA (dietileno triamino pentacetic acid-99 Tc-technetium). From the 41 patients studied, 13 had the GFR (Glomerular filtration rate) Captopril when compared to Basal RDC radioactive, 11 of them were confirmed as having vascular renal disease by Renal Artiography and two of them were false (one case renal litiase and the other chronic pyelonephritis). Two more false negative cases have occurred in the RDC and three patients refused to be submitted to a Renal Arteriography. In the cases which the Total Glomerular Filtration Rate was reduced, there was an agreement of 89,5% between the RDC and the Renal Arteriography. No alterations have been observed in the Renal Arteriography on the remaining 23 patients and in the RDC after Captopril there was normal increase in the Glomerular Filtration Rate when compared to the Basal RDC. The method has showed sensitivity of 84% and specificity of 92%. We can conclude that the RDC with Captopril test is not an invasive method, it has good sensitivity and specificity and it can be indicated as a beginning test to select patients when you intend to detect vascular renal disease; nevertheless the RDC will never be used as a final test of vascular lesion. (author)

  14. Renal artery anatomy affects the blood pressure response to renal denervation in patients with resistant hypertension.

    Science.gov (United States)

    Hering, Dagmara; Marusic, Petra; Walton, Antony S; Duval, Jacqueline; Lee, Rebecca; Sata, Yusuke; Krum, Henry; Lambert, Elisabeth; Peter, Karlheinz; Head, Geoff; Lambert, Gavin; Esler, Murray D; Schlaich, Markus P

    2016-01-01

    Renal denervation (RDN) has been shown to reduce blood pressure (BP), muscle sympathetic nerve activity (MSNA) and target organ damage in patients with resistant hypertension (RH) and bilateral single renal arteries. The safety and efficacy of RDN in patients with multiple renal arteries remains unclear. We measured office and 24-hour BP at baseline, 3 and 6 months following RDN in 91 patients with RH, including 65 patients with single renal arteries bilaterally (group 1), 16 patients with dual renal arteries on either one or both sides (group 2) and 10 patients with other anatomical constellations or structural abnormalities (group 3). Thirty nine out of 91 patients completed MSNA at baseline and follow-up. RDN significantly reduced office and daytime SBP in group 1 at both 3 and 6 months follow-up (Prenal anatomy, the presence of single renal arteries with or without structural abnormalities is associated with a more pronounced BP and MSNA lowering effect than the presence of dual renal arteries in patients with RH. However, when patients with dual renal arteries received renal nerve ablation in all arteries there was trend towards a greater BP reduction. Insufficient renal sympathetic nerve ablation may account for these differences. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. High incidence of secondary hypertension in patients referred for renal denervation

    DEFF Research Database (Denmark)

    Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup

    2014-01-01

    Percutaneous renal denervation is a new treatment option for patients with resistant hypertension and little is known about the eligibility of patients referred. 100 consecutive patients were referred for renal denervation from March 2011 through September 2012. Clinical data were prospectively....... Thus, 91 patients were screened, and of those 51 were found to be candidates for renal denervation. Forty patients were not candidates, of which secondary hypertension was the most common cause (n = 10). Only 51% of patients referred for renal denervation were eligible for treatment. The prevalence...... of secondary hypertension was 10% of the referred population. Secondary hypertension should therefore be considered in the evaluation of candidates for renal denervation....

  16. Baroreflex control of sympathetic activity in experimental hypertension

    Directory of Open Access Journals (Sweden)

    M.C.C. Irigoyen

    1998-09-01

    Full Text Available The arterial baroreceptor reflex system is one of the most powerful and rapidly acting mechanisms for controlling arterial pressure. The purpose of the present review is to discuss data relating sympathetic activity to the baroreflex control of arterial pressure in two different experimental models: neurogenic hypertension by sinoaortic denervation (SAD and high-renin hypertension by total aortic ligation between the renal arteries in the rat. SAD depresses baroreflex regulation of renal sympathetic activity in both the acute and chronic phases. However, increased sympathetic activity (100% was found only in the acute phase of sinoaortic denervation. In the chronic phase of SAD average discharge normalized but the pattern of discharges was different from that found in controls. High-renin hypertensive rats showed overactivity of the renin angiotensin system and a great depression of the baroreflexes, comparable to the depression observed in chronic sinoaortic denervated rats. However, there were no differences in the average tonic sympathetic activity or changes in the pattern of discharges in high-renin rats. We suggest that the difference in the pattern of discharges may contribute to the increase in arterial pressure lability observed in chronic sinoaortic denervated rats.

  17. Antihypertensive effect of rhizome part of Acorus calamus on renal artery occlusion induced hypertension in rats

    Directory of Open Access Journals (Sweden)

    Pinal Patel

    2012-05-01

    Full Text Available Objective: The rhizomes part of Acorus calamus (AC having the calcium inhibitory effect and diuretic activity which may potentiate Na+ excretion in hypertension induced by occlusion of renal artery. Therefore this study was aimed to investigate the effect of AC on experimentally induced hypertension. Methods: Hypertension in rats was induced by clamping the left renal artery for 4h by arterial clamp (2K1C. At the end of experiment animal were anesthetized with ketamine (50 mg/kg. Carotid artery was cannulated which was connected to pressure transducer for estimation of blood pressure. Results: Ethyl acetate extract of Acorus calamus rhizomes (EAAC treated rats that underwent hypertension, demonstrated significant (P < 0.01 lower systolic blood pressure and diastolic blood pressure when compared with 2K1C rats indicated blood pressure lowering activity. Plasma renin activity was significantly (P < 0.05 decreased in EAAC treated rats compared to 2K1C rats. EAAC treated rats that underwent hypertension demonstrated significant (P < 0.01 lower mean blood urea nitrogen and creatinine when compared with 2K1C rats. Lipid peroxidation was significantly (P < 0.001 decreased, where as nitric oxide level in tissue was significantly elevated in EAAC treated rats. Antioxidant enzymes like glutathione, superoxide dismutase and catalase were significantly (P < 0.05, P < 0.01, P < 0.001 increased in EAAC treated rats when compared to 2K1C rats. Conclusions: In conclusions, EAAC treatment attenuated renal artery occlusion induced hypertension via nitric oxide generation and decreases the plasma renin activity.

  18. Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation

    Energy Technology Data Exchange (ETDEWEB)

    VonAchen, Paige [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Hamann, Jason [Boston Scientific Corporation, Maple Grove, MN (United States); Houghland, Thomas; Lesser, John R.; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F. [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Daniels, Mary [Vital Images/Toshiba, Minnetonka, MN (United States); Schwartz, Robert S., E-mail: rss@rsschwartz.com [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States)

    2016-10-15

    Objective: The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Background: Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Methods: Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Results: Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p = 0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p = 0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p = 0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Conclusions: Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in

  19. Captopril {sup 99m}Tc-DTPA Renal Scintigraphy in Diagnosis of Renovascular Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Yang, In Hyung; Lee, Dong Soo; Kim, Sung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1992-07-15

    To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of {sup 99m}Tc-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

  20. Captopril 99mTc-DTPA Renal Scintigraphy in Diagnosis of Renovascular Hypertension

    International Nuclear Information System (INIS)

    Yang, In Hyung; Lee, Dong Soo; Kim, Sung Chul

    1992-01-01

    To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of 99m Tc-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

  1. On the role of renal alpha-adrenergic receptors in spontaneously hypertensive rats

    NARCIS (Netherlands)

    Michel, M. C.; Jäger, S.; Casto, R.; Rettig, R.; Graf, C.; Printz, M.; Insel, P. A.; Philipp, T.; Brodde, O. E.

    1992-01-01

    We tested the hypothesis that a genetically determined increase in renal alpha-adrenergic receptor density might be a pathophysiologically important factor in the spontaneously hypertensive rat model of genetic hypertension. In a first study, we compared renal alpha 1 and alpha 2-adrenergic receptor

  2. Renal scintigraphy by captopril in hypertension with hypokalemia; Scintigraphie renal au captopril dans l`hypertension avec hypokaliemie

    Energy Technology Data Exchange (ETDEWEB)

    Grandet, P.J. [CH PAU, BP 1156, 64046 PAU Universite Cedex (France)

    1997-12-31

    A study on 30 files of hypertensive patients with an associated hypokalemia was achieved from January 1996 to May 1997. The technique was that of a basic examination effected by MAG 3 (80 MBq), followed by oral intake of 25 to 50 mg of Captopril; one hour after, a new examination was done by MAG 3, with 130 MBq. The classical aspect of isotopic nephro-gram (IN) was not constantly found in case of renal artery stenosis. The reduction of the peak of the level approached might be the only sign, even without any delay of this summit; the lowering of the peak after Captopril of at least 50% should be taken into account. Thus, on the basis of these arguments, we have found 5 stenoses of renal artery. Twenty patients considered as normal have had not arteriography and are relatively well-equilibrated by medical treatment. Among the false negatives, one is explained by a renal insufficiency given an IE of bad quality, while the other is a dysplasia of renal arteries. The 3 false positives presented a discrete difference between the two examinations by MAG 3. Consequently, we considered that the discrete signs should not be retained. The slowing down of transit time, the net lowering of the peak or its delay (classically, 11 min) are good arguments

  3. Unilateral renal agenesia in the angiographic material and renovascular hypertension

    International Nuclear Information System (INIS)

    Stojanov, D.; Lovasic, I.; Dujmovic, M.; Bobinac, D.

    1987-01-01

    Analysis of 1216 abdominal aortographies and selective renovasographies undertaken at the Institute of Radiology, Clinical Hospital Centre Rijeka during the period 1979-1985, was performed. 39 (3,2%) unilateral renal agenesias were established, a percentage that is significantly higher than reported by other authors. Analysis of all angiographic parameters of a single kidney was also worked out. A significanlty high percentage (66,7%) of hypertension was diagnosed in this group. Congenital renal failures make their appearance in the early embryological development and are discovered, if compatible with life, most frequently at an advanced age. Statistical data on the frequency during a lifetime are less reliable because a great number of anomalies are never discovered during a person's life. The etiology of variations and congenital failure of renal arteries is unknown in 90% of the cases, and most of the malformations are without characteristic symptomatology. Since the anatomic relations in anomalous kidney are disturbed, the sign of the disease can develop atypical forms causing frequent errors in diagnosis. The kidney is supplied by numerous lateral branches of the medial sacral artery, i.e. the aorta, during embryological development. Later, some of them degenerate or mutually connect themselves, and the definitive kidney has been usually penetrated by only one artery and one vein on the same side (1). If this is not so, i.e. when the obliterations of caudal metanephogenic arteries are only partially present, then the renal arteries emerge from the iliac or lumbar arteries (2,3). Bilateral renal agenesia is extreme and incompatible with life, and hence of small clinical importance. Unilateral agenesia makes its appearance according to various statistics and authors from the obductional materials in ratio 1:1000 (4,5), clinical ones 1:5000 (6, 7, 8) and the angiographically 1:76(9), more exactly 1:35 cases (10). (orig.)

  4. The role of endogenous cardiotonic steroids in pathogenesis of cardiovascular and renal complications of arterial hypertension

    Directory of Open Access Journals (Sweden)

    Aneta Paczula

    2016-03-01

    Full Text Available Endogenous cardiotonic steroids (CTS, also called digitalis-like factors, are a group of steroid hormones linking high salt intake and elevated blood pressure and in part responsible for target organ damage in arterial hypertension. CTS act primarily through their ability to inhibit the ubiquitous transport enzyme sodium-potassium adenosine triphosphatase (Na+/K+-ATPase. A portion of Na+/K+-ATPase does not seem to actively “pump” sodium and potassium but is closely associated with other key signaling proteins. Plasma concentration and urine excretion of CTS are increased in experimental models with volume expansion and on a high salt diet. Elevated plasma concentration of marinobufagenin has been shown in volume-expanded states such as essential hypertension, primary aldosteronism, chronic renal failure, congestive heart failure and pregnancy. In experimental models marinobufagenin induces heart and kidney fibrosis to the same extent as observed in uremia. Neutralization of marinobufagenin with antibodies prevents such heart remodeling. Expanding our understanding of this new class of hormones may lead to development of novel and effective therapeutic strategies in hypertensive patients with renal and cardiovascular complications.

  5. D-α-tocopherol reduces renal damage in hypertensive rats

    Directory of Open Access Journals (Sweden)

    Thaís Maria da Fonseca Pletiskaitz

    2012-06-01

    Full Text Available This study investigated the beneficial effects of D-α-tocopherol supplementation in protecting against the renal morphological and functional changes caused by hypertension. Spontaneously hypertensive (SHR and normotensive control (WKY rats received D-α-tocopherol (80 mg/kg by gavage or vehicle (mineral oil every other day for 60 days, from the age of 2 months. After this treatment period, all animals were assessed for renal morphological and functional parameters. The glomerular hypertrophy, increased interlobular wall thickness and enlarged renal vascular resistance found in SHR were reduced by D-α-tocopherol treatment. Sodium and volume retention observed in SHR were also decreased by D-α-tocopherol treatment. Moreover, D-α-tocopherol supplementation significantly reduced arterial pressure in SHR but not in WKY. D-α-tocopherol also reduced the excretion of thiobarbituric acid-reactive substances (TBARS, a marker of oxidative stress, in SHR. These results suggest that D-α-tocopherol supplementation can reduce kidney damage induced by hypertension.O presente estudo avaliou os efeitos benéficos da suplementação com D-α-tocopherol sobre as alterações morfológicas e funcionais renais causadas pela hipertensão arterial. A partir de dois meses de idade, ratos espontaneamente hipertensos (SHR e controles normotensos (WKY receberam D-α-tocoferol (80 mg/kg por gavagem ou veículo (óleo mineral em dias alternados, por 60 dias. Após este período foram avaliados os parâmetros morfofuncionais dos rins. Os animais SHR apresentaram: hipertrofia glomerular, aumento da espessura da parede das arterias interlobulares e elevação da resistência vascular renal. Estas alterações foram menores nos animais SHR suplementados com D-α-tocoferol. A retenção de sódio e de volume encontrada nos SHR também foi reduzida com o tratamento com D-α-tocoferol. Além disso, a suplementação com D-α-tocoferol reduziu significativamente a press

  6. Exercise renogram. A new approach documents renal involvement in systemic hypertension

    International Nuclear Information System (INIS)

    Clorius, J.H.; Schmidlin, P.

    1983-01-01

    Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. The authors investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

  7. The exercise renogram. A new approach documents renal involvement in systemic hypertension

    International Nuclear Information System (INIS)

    Clorius, J.H.; Schmidlin, P.

    1983-01-01

    Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. We investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

  8. Renal Artery Stenosis in Patients with Resistant Hypertension: Stent It or Not?

    Science.gov (United States)

    Van der Niepen, Patricia; Rossignol, Patrick; Lengelé, Jean-Philippe; Berra, Elena; Sarafidis, Pantelis; Persu, Alexandre

    2017-01-01

    After three large neutral trials in which renal artery revascularization failed to reduce cardiovascular and renal morbidity and mortality, renal artery stenting became a therapeutic taboo. However, this is probably unjustified as these trials have important limitations and excluded patients most likely to benefit from revascularization. In particular, patients with severe hypertension were often excluded and resistant hypertension was either poorly described or not conform to the current definition. Effective pharmacological combination treatment can control blood pressure in most patients with renovascular hypertension. However, it may also induce further renal hypoperfusion and thus accelerate progressive loss of renal tissue. Furthermore, case reports of patients with resistant hypertension showing substantial blood pressure improvement after successful revascularization are published over again. To identify those patients who would definitely respond to renal artery stenting, properly designed randomized clinical trials are definitely needed.

  9. Severe Hypertension Secondary to Renal Artery Stenosis and Cushing's Syndrome

    International Nuclear Information System (INIS)

    Al-Zahrani, Ali S.; Al-Hajjaj, Alya; Al-Watban, Jehad; Kanaan, Imaduddin

    2005-01-01

    We present an unusual patient who simultaneously had severe renal artery stenosis RAS and Cushings syndrome. The case highlights the difficulty of reaching a specific diagnosis of Cushings syndrome and the possible interaction between Cushings syndrome and some other concurrent illnesses that this patient had. A 37-year old man presented with severe hypertension HTN and uncontrolled diabetes mellitus DM without clear physical signs of Cushings syndrome. He was found to have severe osteoporosis, proximal myopathy, several cutaneous warts, tinea versicolor, and chronic viral hepatitis. Captopril-stimulated renal scan and renal artery angiogram revealed severe RAS. Partial balloon dilatation of RAS led to improvement in HTN. Unexpectedly, urine free cortisol 24 hour was found extremely high. Serum adrenocorticotropic hormone ACTH was also elevated and high dose dexamethasone suppression tests were inconclusive. Several imaging studies failed to localize the source of ACTH. Despite normal MRI of the pituitary gland, bilateral inferior petrosal sinus sampling IPSS localized the source of ACTH secretion to the right side of the pituitary gland and right anterior hemihypophysectomy resulted in cure of Cushings disease, HTN, DM, and tinea versicolor with significant improvement in cutaneous warts, osteoporosis, and chronic hepatitis. In conclusion, RAS and Cushings syndrome may occur together. Significant hypercortisolemia can occur without clear signs of Cushings syndrome. Controlling hypercortisolemia is of paramount importance when treating chronic infections in patients with Cushing's syndrome. (author)

  10. Radioisotopic investigation of renal arterial hypertension using 99m Tc-DTPA

    International Nuclear Information System (INIS)

    Champailler, A.; Defour-Decousus, M.; Houzard, C.; Healy, J.C.; Gonthier, R.; Juge, J.; Berthoux, F.C.

    1984-01-01

    To evaluate the clinical validity of renal investigation using 99m Tc-DTPA, 60 hypertensive patients divided into four groups according to diagnosis were studied: 1) renovascular hypertension (22 patients); 2) chronic pyelo-nephritis (11 patients); 3) renal hypoplasia (12 patients); 4) hypertension due to bilateral parenchymatous (15 patients). A good correlation was found between clearance of DTPA and creatinine clearance/1.73 m 2 body surface (n = 51, r = 0.68, p 2 BS [fr

  11. Dynamic modeling of renal blood flow in Dahl hypertensive and normotensive rats

    DEFF Research Database (Denmark)

    Knudsen, Torben; Elmer, Henrik; Knudsen, Morten H

    2004-01-01

    A method is proposed in this paper which allows characterization of renal autoregulatory dynamics and efficiency using quantitative mathematical methods. Based on data from rat experiments, where arterial blood pressure and renal blood flow are measured, a quantitative model for renal blood flow ...... describe myogenic responses and tubuloglomerular feedback responses separately. The method is applied to data from normo- and hypertensive Dahl rats, and a discriminator that separates data from normotensive Dahl R rats and hypertensive Dahl S rats is constructed....

  12. Renal denervation in the treatment of resistant hypertension: Dead, alive or surviving?

    Science.gov (United States)

    Al-Fakhouri, Ahmad; Efeovbokhan, Nephertiti; Nakhla, Rami; Khouzam, Rami N

    2016-10-01

    Hypertension is one of the most common chronic clinical problems encountered by physicians. The prevalence of resistant hypertension is estimated at 9% in the US. Patients with resistant hypertension have been shown to be at higher risk for adverse cardiovascular events, hence the need for greater efforts in improving the treatment of hypertension. The renal sympathetic nerves play an important role in the development of hypertension, mediated via sodium and water retention, increased renin release and alterations in renal blood flow. The proximity of the afferent and efferent renal sympathetic nerves to the adventitia of the renal arteries suggested the feasibility of an endovascular, selective, minimally invasive approach to renal denervation; a potential treatment option for resistant hypertension. While the RAPID, Reduce-HTN, EnligHTN, DENERHTN and Symplicity HTN-1 and -2 studies showed significant benefit of renal denervation in the treatment of resistant hypertension, the results of Oslo RDN, Prague-15 and Symplicity HTN-3 were not so favorable. Future well-designed clinical trials are needed to ascertain the benefits or otherwise of renal denervation in treatment-resistant hypertension. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Renal hypertension and cardiovascular disorder in children with chronic kidney disease.

    Science.gov (United States)

    Peco-Antić, Amira; Paripović, Dusan

    2014-01-01

    Renal hypertension is one of the earliest and the most prevalent complications of pediatric chronic kidney disease (CKD). Among renal patients, hypertension is frequently underdiagnosed and undertreated. For casual blood pressure measurement, the best method is auscultatory, while for ambulatory blood pressure measurement, oscillometric method is the most commonly used. Both casual and ambulatory blood pressure measurement provide more powerful means of diagnosing hypertension. Masked hypertension is a condition in which casual blood pressure is normal but ambulatory blood pressure is elevated. The risk of cardiovascular morbidity and mortality is higher with masked hypertension as compared to the controls. Children and adolescents with CKD are at high risk of cardiovascular disease that has been established as the leading cause of death in patients with end stage renal disease. Left ventricular hypertrophy remains the most thoroughly documented form of end-organ damage caused by hypertension in children and adolescents with CKD. Based on clear evidence on the correlation between blood pressure and cardiovascular morbidity, mortality, and renal function, renal hypertension must be aggressively treated. Target blood pressure for patients with renal hypertension should be at low normal values: < 75 percentile for patients without proteinuria and <50 percentile for patients with proteinuria. Renin-angiotensin system antagonists are considered the first choice pharmacological option in hypertensive CKD 2-4 patients while the management of volume overload is the most important in dialysis patients. Successful transplantation can eliminate or significantly improve uremia-related cardiovascular risk factors and increase predicted life expectancy.

  14. Treatment of hypertension and renal injury induced by the angiogenesis inhibitor sunitinib: preclinical study.

    Science.gov (United States)

    Lankhorst, Stephanie; Kappers, Mariëtte H W; van Esch, Joep H M; Smedts, Frank M M; Sleijfer, Stefan; Mathijssen, Ron H J; Baelde, Hans J; Danser, A H Jan; van den Meiracker, Anton H

    2014-12-01

    Common adverse effects of angiogenesis inhibition are hypertension and renal injury. To determine the most optimal way to prevent these adverse effects and to explore their interdependency, the following drugs were investigated in unrestrained Wistar Kyoto rats exposed to the angiogenesis inhibitor sunitinib: the dual endothelin receptor antagonist macitentan; the calcium channel blocker amlodipine; the angiotensin-converting enzyme inhibitor captopril; and the phosphodiesterase type 5 inhibitor sildenafil. Mean arterial pressure was monitored telemetrically. After 8 days, rats were euthanized and blood samples and kidneys were collected. In addition, 24-hour urine samples were collected. After sunitinib start, mean arterial pressure increased rapidly by ≈30 mm Hg. Coadministration of macitentan or amlodipine largely prevented this rise, whereas captopril or sildenafil did not. Macitentan, captopril, and sildenafil diminished the sunitinib-induced proteinuria and endothelinuria and glomerular intraepithelial protein deposition, whereas amlodipine did not. Changes in proteinuria and endothelinuria were unrelated. We conclude that in our experimental model, dual endothelin receptor antagonism and calcium channel blockade are suitable to prevent angiogenesis inhibition-induced hypertension, whereas dual endothelin receptor antagonism, angiotensin-converting enzyme inhibitor, and phosphodiesterase type 5 inhibition can prevent angiogenesis inhibition-induced proteinuria. Moreover, the variable response of hypertension and renal injury to different antihypertensive agents suggests that these side effects are, at least in part, unrelated. © 2014 American Heart Association, Inc.

  15. ASSOCIATION OF LOWER ANTIOXIDANT STATUS WITH ESTIMA TED GFR IN HYPERTENSIVES WITH PRESERVED RENAL FUNCTION

    OpenAIRE

    Roma; Rasmita Kumari; Nirupama; Suvendu Sekhar; Srikrushna

    2013-01-01

    ABSTRACT: BACKGROUND AND OBJECTIVES : Renal dysfunction is end organ damage in hypertension. We investigated the association of oxi dative stress with estimated glomerular filtration rate in hypertension. METHODS : A total of 116 hypertensive individuals (age 47 ± 10.2 years; 68% males; BMI < 25; without diabetes m ellitus, CVD) were included. All the hypertensive subjects were albustix negative. Fastin g blood glucose, lipid profile, urea and creatinine was e...

  16. Diabetes, hypertension, obesity, and long-term risk of renal disease mortality: Racial and socioeconomic differences.

    Science.gov (United States)

    Moghani Lankarani, Maryam; Assari, Shervin

    2017-07-01

    Diabetes, hypertension, and obesity increase the risk of chronic kidney disease and associated mortality. Race and socioeconomic status (SES) differences in the effects of these risk factors are, however, still unknown. The current study aimed to investigate whether or not race and SES alter the effects of diabetes, hypertension, and obesity on mortality due to renal disease. Data came from the Americans' Changing Lives Study, 1986-2011, a nationally representative prospective cohort of adults with 25 years of follow up. The study included 3,361 adults aged 25 years and older who were followed for up to 25 years. The outcome was death from renal disease. Diabetes, hypertension, and obesity were the main predictors. Race and SES (education, income, and employment) were moderators. Health behaviors and health status at baseline were covariates. We used Cox proportional hazards models for data analysis. In separate models, diabetes, hypertension, and obesity at baseline were associated with a higher risk of death from renal disease. From our SES indicators, education and income interacted with diabetes, hypertension, and obesity on death from renal disease. In a consistent pattern, diabetes, hypertension, and obesity showed stronger effects on the risk of death from renal disease among high-SES groups compared with low-SES individuals. Race and employment did not alter the effects of diabetes, hypertension and obesity on the risk of death from renal disease. Social groups differ in how diabetes, hypertension, and obesity influence health outcomes over long-term periods. Elimination of disparities in renal disease mortality in the USA requires understanding of the complex and non-linear effects of socioeconomic and medical risk factors on health outcomes. Multidisciplinary programs and policies are required to reduce social inequality in renal disease burden caused by diabetes, hypertension, and obesity. © 2017 The Authors. Journal of Diabetes Investigation published

  17. Effects of converting enzyme inhibition on split renal function in renovascular hypertension

    International Nuclear Information System (INIS)

    Miyamori, I.; Yasuhara, S.; Takeda, Y.

    1986-01-01

    The effects of captopril on effective renal plasma flow and glomerular filtration rate were studied using a noninvasive radioisotopic method on individual kidneys in eight patients with renovascular hypertension and 12 patients with essential hypertension with various renin levels. Four patients with renovascular hypertension had unilateral while three had bilateral renal artery stenosis. The effective renal plasma flow and glomerular filtration rate were determined by using 131 I-iodohippurate sodium and /sup 99m/Tc-diethylenetriamine pentaacetic acid, respectively. Glomerular filtration rate and effective renal plasma flow were significantly reduced in the stenotic kidneys of patients with renovascular hypertension compared with values in nonstenotic kidneys (p less than 0.01). Treatment with captopril, 37.5 to 75 mg/day for 1 to 48 weeks, further reduced the glomerular filtration rate only in stenotic kidneys, and effective renal plasma flow increased in both kidney types. In two of the three renal hypertensive patients with bilateral renal artery stenosis, captopril produced a reversible azotemia that was unrelated to the fall in blood pressure, as evidenced by the lack of azotemia seen after a moderate blood pressure reduction induced by other antihypertensive medications. These results indicate that endogenous angiotensin II is essential in maintaining the glomerular filtration rate in stenotic kidneys and suggest that a reduction in glomerular filtration rate during captopril administration could indicate the presence of renal artery stenosis

  18. Renal Oxidative Stress Induced by Long-Term Hyperuricemia Alters Mitochondrial Function and Maintains Systemic Hypertension

    Directory of Open Access Journals (Sweden)

    Magdalena Cristóbal-García

    2015-01-01

    Full Text Available We addressed if oxidative stress in the renal cortex plays a role in the induction of hypertension and mitochondrial alterations in hyperuricemia. A second objective was to evaluate whether the long-term treatment with the antioxidant Tempol prevents renal oxidative stress, mitochondrial alterations, and systemic hypertension in this model. Long-term (11-12 weeks and short-term (3 weeks effects of oxonic acid induced hyperuricemia were studied in rats (OA, 750 mg/kg BW, OA+Allopurinol (AP, 150 mg/L drinking water, OA+Tempol (T, 15 mg/kg BW, or vehicle. Systolic blood pressure, renal blood flow, and vascular resistance were measured. Tubular damage (urine N-acetyl-β-D-glucosaminidase and oxidative stress markers (lipid and protein oxidation along with ATP levels were determined in kidney tissue. Oxygen consumption, aconitase activity, and uric acid were evaluated in isolated mitochondria from renal cortex. Short-term hyperuricemia resulted in hypertension without demonstrable renal oxidative stress or mitochondrial dysfunction. Long-term hyperuricemia induced hypertension, renal vasoconstriction, tubular damage, renal cortex oxidative stress, and mitochondrial dysfunction and decreased ATP levels. Treatments with Tempol and allopurinol prevented these alterations. Renal oxidative stress induced by hyperuricemia promoted mitochondrial functional disturbances and decreased ATP content, which represent an additional pathogenic mechanism induced by chronic hyperuricemia. Hyperuricemia-related hypertension occurs before these changes are evident.

  19. Insufficient therapeutic management of hypertensive patients with renal failure in France.

    Science.gov (United States)

    P-Guérin, Alain; Maumus-Robert, Sandy; Zin, Adeline

    2008-01-01

    Hypertension is both the cause and consequence of chronic renal failure (CRF). The prevalence of CRF, which itself is a cardiovascular risk factor, is not well known in France. To estimate the prevalence of renal dysfunction among hypertensive patients who were seen by general practitioners (GP); to assess the drug management of hypertension in these patients according to their renal status. A transversal observational study among patients of both genders aged 18 or more, with arterial blood pressure greater than 130/80 mmHg (i.e., over CRF-recommended blood pressure) or under antihypertensive drugs who were recruited in France by GP. Among the 2315 included patients, 1908 could be analyzed for their renal function. Of these, 70.5% had an estimated glomerular filtration rate (GFR) of 89 ml/min per 1.73 m(2) or lower. One third of these patients (31.4%) were suffering from renal failure (GFRrenal status. Hypertensive patients who are seen by GP have a high level of renal disturbances and many of them do not reach recommended blood pressure values. This highlights the importance of an early detection of renal dysfunction avoiding progression towards end-stage renal failure and an adapted antihypertensive drugs prescription, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blocker, acting as renal protectors.

  20. Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization

    International Nuclear Information System (INIS)

    Docx, Martine K.; Vandenberghe, Philippe; Maleux, Geert; Gewillig, Marc; Mertens, Luc

    2009-01-01

    A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension. Only selective angiography was able to demonstrate the subsegmental artery stenosis in this patient. (orig.)

  1. Vasomotion of renal blood flow in essential hypertension. Oscillations in xenon transit

    International Nuclear Information System (INIS)

    Hollenberg, N.K.; Sandor, T.

    1984-01-01

    To assess the frequency and magnitude of phasic renal blood flow changes in essential hypertension, we applied an analytical method based on the estimation of power spectral density to xenon transit through the kidney. Despite similar age and gender distribution of the patients and exclusion of those with accelerated hypertension, mean renal blood flow was significantly lower in 100 patients with essential hypertension (299 +/- 8 ml/100 g/min) than in the 144 normal subjects (335 +/- 6 ml/100 g/min; p less than 0.001). Normalized power, the index of oscillatory behavior, was more than twice normal in patients with essential hypertension (p less than 0.001), but there was no difference in the frequency or cycle length of the oscillation. Two maneuvers that induced renal vasoconstriction, the application of cuffs to the thighs which were then inflated to diastolic blood pressure and an emotional provocation, reduced renal blood flow much more in patients with essential hypertension (p less than 0.01) in association with a striking increase in normalized power (p less than 0.001). The oscillations, which reflected not the phasic blood pressure change but rather the phasic change in renal perfusion, provided additional evidence that renal vasoconstriction plays an active role in the pathogenesis of essential hypertension

  2. Renal Doppler evaluation in the child with hypertension: a reasonable screening discriminator?

    Science.gov (United States)

    Chhadia, Sumit; Cohn, Richard A; Vural, Gulsah; Donaldson, James S

    2013-12-01

    Hypertension is diagnosed in 1-5% of children, and 5-10% of those hypertensive children have renovascular disease. The gold standard for a diagnosis of renal artery stenosis is arteriography, and Doppler ultrasound (Doppler US) continues to be advocated as a useful screening test. The purpose of this study was to determine the utility of Doppler US in children as a screening tool and to better define clinical features of children in whom arteriography should be performed. This retrospective study evaluated the imaging and clinical parameters for all children who had a renal US with Doppler followed by a diagnostic arteriogram for the evaluation of hypertension during a 12-year period at a tertiary children's hospital. Sixty-two children were included. We evaluated each child's clinical parameters and placed each child into one of three categories of hypertension: mild, moderate or severe. Eleven of 17 kidneys with proven renal artery stenosis were detected with Doppler US (sensitivity 64%). Six children with renal artery stenosis were missed by Doppler US, four of whom had segmental artery lesions. Of the children with positive renal artery stenosis on arteriography, all but three (79%) were classified as having moderate to severe hypertension. Doppler US is a useful screening examination when evaluating children with hypertension, detecting renal artery stenosis in most affected children. The clinical risk classifications are helpful in guiding which children should proceed with arteriography regardless of the Doppler US results.

  3. Selective renal vasoconstriction, exaggerated natriuresis and excretion rates of exosomic proteins in essential hypertension

    DEFF Research Database (Denmark)

    Damkjaer, M.; Jensen, Pia Hønnerup; Schwämmle, Veit

    2014-01-01

    AimIn essential hypertension (EH), the regulation of renal sodium excretion is aberrant. We hypothesized that in mild EH, (i) abnormal dynamics of plasma renin concentration (PRC) and atrial natriuretic peptide (ANP) are responsible for the exaggerated natriuresis, and (ii) exosomic protein...... patterns reflect the renal tubular abnormality involved in the dysregulation of sodium excretion. MethodsAfter 2-week drug washout and 4-day diet, systemic and renal hemodynamics, cardio-renal hormones, glomerular filtration and renal excretion were studied in male patients during saline loading (SL...

  4. The diagnosis of renovascular hypertension: the role of captopril renal scintigraphy and related issues

    Energy Technology Data Exchange (ETDEWEB)

    Prigent, A. (Service d' Explorations Fonctionnelles et de Medecine Nucleaire, Hopital Broussais, 75 - Paris (France))

    1993-07-01

    This article reviews the screening and diagnostic tests used in the detection of significant renal artery stenosis and renovascular hypertension. After addressing the pathophysiological considerations necessary for correct diagnostic test interpretation, this review critically surveys the recent advances in, and the limitations of, relevant investigational procedures and in particular focusses on the efficacy and issues of angiotensin-converting enzyme inhibitor renal scintigraphy. (orig.)

  5. Combined Pulmonary Hypertension and Renal Thrombotic Microangiopathy in Cobalamin C Deficiency

    NARCIS (Netherlands)

    Komhoff, Martin; Roofthooft, Marcus T.; Westra, Dineke; Teertstra, Thea K.; Losito, Attilio; de Kar, Nicole C. A. J. van; Berger, Rolf M. F.

    Pulmonary arterial hypertension (PAH) and renal thrombotic microangiopathy (rTMA) are rare diseases in childhood, frequently leading to death and end-stage renal disease, respectively. Their combined occurrence has been reported anecdotally. We investigated the clinical, biochemical, and genetic

  6. Diminished response to furosemide in I-123 Hippuran renal studies of renovascular hypertension caused by unilateral renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Flueckiger, F.M.; Fueger, G.F.; Einspieler, R.; Hausegger, K. (Department of Radiology, Graz (Austria))

    1990-09-01

    Dynamic I-123 Hippuran renal studies to measure furosemide response (FR) were performed in three groups of patients: (1) 57 patients with renovascular hypertension due to a poststenotic, ischemic kidney; (2) 23 patients with essential hypertension; and (3) 50 nonhypertensive patients with healthy kidneys (control group). FR was observed as renal parenchymal tracer washout within 10 minutes after the injection of 40 mg of furosemide. The retention index (RI) took into consideration the renal parenchymal tracer content before and 10 minutes after furosemide injection. In the control group, the FR was greater than 50% and the RI was less than 20. Patients with essential hypertension revealed no differences in the amounts of FR and RI compared with the control group. In renovascular hypertension, the FR was diminished and the RI was raised significantly. The values of FR and RI showed a good correlation to the degree of the renal artery stenosis before and after percutaneous transluminal angioplasty. It is concluded that the stimulation of diuresis with furosemide and its quantification represent an important additional step in the evaluation of dynamic I-123 Hippuran studies to detect renal ischemia.

  7. Hypertension in kidney transplantation is associated with an early renal nerve sprouting.

    Science.gov (United States)

    Mauriello, Alessandro; Rovella, Valentina; Borri, Filippo; Anemona, Lucia; Giannini, Elena; Giacobbi, Erica; Saggini, Andrea; Palmieri, Giampiero; Anselmo, Alessandro; Bove, Pierluigi; Melino, Gerry; Valentina, Guardini; Tesauro, Manfredi; Gabriele, D'Urso; Di Daniele, Nicola

    2017-06-01

    Normalization of arterial pressure occurs in just a few patients with hypertensive chronic kidney disease undergoing kidney transplantation. Hypertension in kidney transplant recipients may be related to multiple factors. We aimed to assess whether hypertension in kidney-transplanted patients may be linked to reinnervation of renal arteries of the transplanted kidney. We investigated renal arteries innervation from native and transplanted kidneys in three patients 5 months, 2 years and 11 years after transplantation, respectively. Four transplanted kidneys from non-hypertensive patients on immunosuppressive treatment without evidence of hypertensive arteriolar damage were used as controls. . Evidence of nerve sprouting was observed as early as 5 months following transplantation, probably originated from ganglions of recipient patient located near the arterial anastomosis and was associated with mild hypertensive arteriolar damage. Regeneration of periadventitial nerves was already complete 2 years after transplantation. Nerve density tended to reach values observed in native kidney arteries and was associated with hypertension-related arteriolar lesions in transplanted kidneys. Control kidneys, albeit on an immunosuppressive regimen, presented only a modest regeneration of sympathetic nerves. . Our results suggest that the considerable increase in sympathetic nerves, as found in patients with severe arterial damage, may be correlated to hypertension rather than to immunosuppressive therapy, thus providing a morphological basis for hypertension recurrence despite renal denervation. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  8. Computer-assisted static/dynamic renal imaging: a screening test for renovascular hypertension

    International Nuclear Information System (INIS)

    Keim, H.J.; Johnson, P.M.; Vaughan, E.D. Jr.; Beg, K.; Follett, D.A.; Freeman, L.M.; Laragh, J.H.

    1979-01-01

    Computer-assisted static/dynamic renal imaging with [ 197 Hg] chlormerodrin and [/sup 99m/Tc] pertechnetate was evaluated prospectively as a screening test for renovascular hypertension. Results are reported for 51 patients: 33 with benign essential hypertension and 18 with renovascular hypertension, and for 21 normal controls. All patients underwent renal arteriography. Patients with significant obesity, renal insufficiency, or renoparenchymal disease were excluded from this study. Independent visual analyses of renal gamma images and time-activity transit curves identified 17 of the 18 patients with renovascular hypertension; one study was equivocal. There were five equivocal and three false-positive results in the essential hypertension and normal control groups. The sensitivity of the method was 94% and the specificity 85%. Since the prevalence of the renovascular subset of hypertension is approximately 5%, the predictive value is only 25%. Inclusion of computer-generated data did not improve this result. Accordingly, this method is not recommended as a primary screening test for renovascular hypertension

  9. Role of the Sympathetic Nervous System and Its Modulation in Renal Hypertension

    Directory of Open Access Journals (Sweden)

    Yusuke Sata

    2018-03-01

    Full Text Available The kidneys are densely innervated with renal efferent and afferent nerves to communicate with the central nervous system. Innervation of major structural components of the kidneys, such as blood vessels, tubules, the pelvis, and glomeruli, forms a bidirectional neural network to relay sensory and sympathetic signals to and from the brain. Renal efferent nerves regulate renal blood flow, glomerular filtration rate, tubular reabsorption of sodium and water, as well as release of renin and prostaglandins, all of which contribute to cardiovascular and renal regulation. Renal afferent nerves complete the feedback loop via central autonomic nuclei where the signals are integrated and modulate central sympathetic outflow; thus both types of nerves form integral parts of the self-regulated renorenal reflex loop. Renal sympathetic nerve activity (RSNA is commonly increased in pathophysiological conditions such as hypertension and chronic- and end-stage renal disease. Increased RSNA raises blood pressure and can contribute to the deterioration of renal function. Attempts have been made to eliminate or interfere with this important link between the brain and the kidneys as a neuromodulatory treatment for these conditions. Catheter-based renal sympathetic denervation has been successfully applied in patients with resistant hypertension and was associated with significant falls in blood pressure and renal protection in most studies performed. The focus of this review is the neural contribution to the control of renal and cardiovascular hemodynamics and renal function in the setting of hypertension and chronic kidney disease, as well as the specific roles of renal efferent and afferent nerves in this scenario and their utility as a therapeutic target.

  10. Effects of chronic sympatho-inhibition on renal excretory function in renovascular hypertension.

    Science.gov (United States)

    Burke, Sandra L; Evans, Roger G; Head, Geoffrey A

    2011-05-01

    Treatment of renovascular hypertension with drugs that directly target the renin-angiotensin system may compromise glomerular filtration and renal excretory function, leading to renal failure. Centrally acting sympathoinhibitory agents also inhibit the renin-angiotensin system, so we determined whether this treatment modality alters renal excretory function in rabbits with renovascular hypertension. Rabbits were equipped with bilateral renal artery flow probes and a renal nerve electrode. Hypertension was induced with a renal artery clip (2K1C) or rabbits were sham-clipped. After 2 weeks, a subcutaneous minipump was implanted to deliver rilmenidine (2.5 mg/kg per day) or vehicle for 3 weeks. Haemodynamic variables and renal function were studied under control conditions and during intravenous infusion of isotonic saline (154 mmol/l NaCl) at increasing rates of 4, 12 and 36 ml/kg per hour. Mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) were greater in 2K1C rabbits than sham-clipped rabbits, but total urine flow, sodium excretion and glomerular filtration rate were similar in the two groups. In 2K1C rabbits, rilmenidine reduced MAP to close to control levels and reduced RSNA (40%), but did not significantly alter basal renal blood flow, glomerular filtration rate, urine flow or sodium excretion. The natriuretic response to isotonic saline load in 2K1C rabbits was not significantly altered by rilmenidine. These observations show that chronic treatment of rabbits with renal artery stenosis with a centrally acting sympathoinhibitory agent, despite normalizing MAP, does not compromise renal excretory function. Thus, this treatment modality may be particularly useful in renovascular hypertension. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

  11. Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Amraoui Fouad

    2012-07-01

    Full Text Available Abstract Background Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension. Methods Retrospective analysis of patients admitted with malignant hypertension in Amsterdam, the Netherlands between August 1992–January 2010. Follow-up data on vital status, renal function and blood pressure (BP were obtained from the outpatient department and from general practitioners. The primary composite endpoint was end-stage renal disease (ESRD defined as the start of kidney replacement therapy (KRT or ≥ 50% decline of estimated glomerular filtration rate (eGFR. The secondary endpoint was all cause mortality. Results A total of 120 patients admitted with malignant hypertension were included. After a median follow-up period of 67 months (IQR 28 to 108 months the primary endpoint was reached by 37 (31% patients, whereas 18 patients (15% reached the secondary endpoint. Twenty-nine (24% patients started KRT and 8 patients (7% had an eGFR decline ≥ 50%. After the acute phase (> 3 months after admission, initial serum creatinine and follow-up BP were the main predictors of future ESRD with hazard ratios of 6.1 (95% CI, 2.2–17 for patients with initial serum creatinine ≥ 175 μmol /L and 4.3 (95% CI, 1.4–14 for patients with uncontrolled hypertension. Conclusions Progressive renal function decline leading to ESRD remains a major threat to patients with malignant hypertension. BP control during follow-up was an important modifiable predictor of renal outcome.

  12. Aortic coarctation diagnosed by renal Doppler flow patterns in a hypertensive young patient: a case report

    International Nuclear Information System (INIS)

    Sari, S.; Kara, K.; Verim, S.

    2012-01-01

    Full text: Introduction: Aortic coarctation is a congenital malformation, which can cause systemic hypertension and subsequent complications, and causes of secondary hypertension, affecting in differential pressures in the upper and lower extremities. Because hypertension is caused by aortic coarctation, tends to be resistant to medical therapy, early recognition and surgical rectification are important. Objectives and tasks: In this article, we aimed to point out that renal Doppler sonography is a beneficial and frequently used to evaluate secondary hypertension, if there are bilateral tardus-parvus wave patterns are detected. Thus, bilateral renal artery stenosis, aortic stenosis, and coarctation should be considered in this condition. Materials and methods: A 23-year-old male who has six-month history of hypertension. He was referred by a cardiologist for investigation of his secondary hypertension. There was an ascending aortic dilatation, left ventricular hypertrophy in his echocardiography. Results: The patient's blood pressure was measured as 160/90 mm Hg in his both arms. Renal Doppler sonography was performed to identify the potential cause of secondary hypertension, specifically renal artery stenosis, after tardus-parvus pulse waves were noted in both renal intralobar-arteries. Aortic coarctation is suspected and then a chest computed tomography (CT) was performed to evaluate supra-diaphragmatic vessel abnormalities. The CT exposed a stenotic lesion in the isthmus of the aorta. The patient was transferred to cardiovascular surgery department for treatment. Conclusion: Careful physical examination should be performed in all hypertensive patients. If bilateral tardus-parvus wave pattern are seen in patients who has been referred for Doppler evaluation on suspicion of renovascular hypertension, aortic coarctation should be considered as differential diagnosis

  13. [The role of arachidonic acid metabolites in the regulation of renal function and pathogenesis of hypertension].

    Science.gov (United States)

    Certíková Chábová, V

    2008-01-01

    Eicosanoids are twenty-carbon compounds derived from arachidonic acid. Lipoxygenases, cyclooxygenases and cytochrome P-450 enzymes contribute to their synthesis. Our review is focused on prostaglandins, leucotrienes, lipoxins, hepoxilins, hydroxyeicosatetraenoic acids, and epoxyeicosatrienoic acids. Most of these compounds have multiple functions and they also participate in blood pressure regulation and excretion of water and solutes in the kidney. They have some roles in the patogenesis of kidney disease, too. Both experimental models (mainly geneticaly modified mice and rats) and human epidemiological and genetical studies are used in the investigation of eicosanoid physiological and patophysiological functions. New information about their enzymatic regulations and receptors have already resulted in the development of new drugs, mainly antiasthmatics, but further investigation should bring about new results in the treatment of hypertension and other cardiovascular and renal diseases.

  14. Captopril attenuates hypertension and renal injury induced by the vascular endothelial growth factor inhibitor sorafenib

    Science.gov (United States)

    Nagasawa, Tasuku; Khan, Abdul Hye; Imig, John D

    2013-01-01

    SUMMARY Vascular endothelial growth factor inhibitors (VEGFi) are known to cause hypertension and renal injury that severely limits their use as an anticancer therapy. We hypothesized that the angiotensin-converting enzyme inhibitor captopril not only prevents hypertension, but also decreases renal injury caused by the VEGFi sorafenib.Rats were administered sorafenib (20 mg/kg per day) alone or in combination with captopril (40 mg/kg per day) for 4 weeks. Sorafenib administration increased blood pressure, which plateaued by day 10.Concurrent treatment with captopril for 4 weeks resulted in a 30 mmHg decrease in blood pressure compared with sorafenib alone (155 ± 5 vs 182 ± 6 mmHg, respectively; P captopril treatment reduced albuminuria by 50% compared with sorafenib alone (20 ± 8 vs 42 ± 9 mg/day, respectively; P captopril-treated rats administered sorafenib. Renal autoregulatory efficiency was determined by evaluating the afferent arteriolar constrictor response to ATP. Sorafenib administration attenuated the vasoconstriction to ATP, whereas concurrent captopril treatment improved ATP reactivity.In conclusion, captopril attenuated hypertension and renal injury and improved renal autoregulatory capacity in rats administered sorafenib. These findings indicate that captopril treatment, in addition to alleviating the detrimental side-effect of hypertension, decreases the renal injury associated with anticancer VEGFi therapies such as sorafenib. PMID:22443474

  15. The calcineurin inhibitor tacrolimus activates the renal sodium chloride cotransporter to cause hypertension.

    Science.gov (United States)

    Hoorn, Ewout J; Walsh, Stephen B; McCormick, James A; Fürstenberg, Antje; Yang, Chao-Ling; Roeschel, Tom; Paliege, Alexander; Howie, Alexander J; Conley, James; Bachmann, Sebastian; Unwin, Robert J; Ellison, David H

    2011-10-02

    Calcineurin inhibitors (CNIs) are immunosuppressive drugs that are used widely to prevent rejection of transplanted organs and to treat autoimmune disease. Hypertension and renal tubule dysfunction, including hyperkalemia, hypercalciuria and acidosis, often complicate their use. These side effects resemble familial hyperkalemic hypertension, a genetic disease characterized by overactivity of the renal sodium chloride cotransporter (NCC) and caused by mutations in genes encoding WNK kinases. We hypothesized that CNIs induce hypertension by stimulating NCC. In wild-type mice, the CNI tacrolimus caused salt-sensitive hypertension and increased the abundance of phosphorylated NCC and the NCC-regulatory kinases WNK3, WNK4 and SPAK. We demonstrated the functional importance of NCC in this response by showing that tacrolimus did not affect blood pressure in NCC-knockout mice, whereas the hypertensive response to tacrolimus was exaggerated in mice overexpressing NCC. Moreover, hydrochlorothiazide, an NCC-blocking drug, reversed tacrolimus-induced hypertension. These observations were extended to humans by showing that kidney transplant recipients treated with tacrolimus had a greater fractional chloride excretion in response to bendroflumethiazide, another NCC-blocking drug, than individuals not treated with tacrolimus; renal NCC abundance was also greater. Together, these findings indicate that tacrolimus-induced chronic hypertension is mediated largely by NCC activation, and suggest that inexpensive and well-tolerated thiazide diuretics may be especially effective in preventing the complications of CNI treatment.

  16. Role of Angiotensin II type 1 receptor on renal NAD(P)H oxidase, oxidative stress and inflammation in nitric oxide inhibition induced-hypertension.

    Science.gov (United States)

    Rincón, J; Correia, D; Arcaya, J L; Finol, E; Fernández, A; Pérez, M; Yaguas, K; Talavera, E; Chávez, M; Summer, R; Romero, F

    2015-03-01

    Activation of the renin-angiotensin system (RAS), renal oxidative stress and inflammation are constantly present in experimental hypertension. Nitric oxide (NO) inhibition with N(w)-nitro-L-arginine methyl ester (L-NAME) has previously been reported to produce hypertension, increased expression of Angiotensin II (Ang II) and renal dysfunction. The use of Losartan, an Ang II type 1 receptor (AT1R) antagonist has proven to be effective reducing hypertension and renal damage; however, the mechanism by which AT1R blockade reduced kidney injury and normalizes blood pressure in this experimental model is still complete unknown. The current study was designed to test the hypothesis that AT1R activation promotes renal NAD(P)H oxidase up-regulation, oxidative stress and cytokine production during L-NAME induced-hypertension. Male Sprague-Dawley rats were distributed in three groups: L-NAME, receiving 70 mg/100ml of L-NAME, L-NAME+Los, receiving 70 mg/100ml of L-NAME and 40 mg/kg/day of Losartan; and Controls, receiving water instead of L-NAME or L-NAME and Losartan. After two weeks, L-NAME induced high blood pressure, renal overexpression of AT1R, NAD(P)H oxidase sub-units gp91, p22 and p47, increased levels of oxidative stress, interleukin-6 (IL-6) and interleukin-17 (IL-17). Also, we found increased renal accumulation of lymphocytes and macrophages. Losartan treatment abolished the renal expression of gp91, p22, p47, oxidative stress and reduced NF-κB activation and IL-6 expression. These findings indicate that NO induced-hypertension is associated with up-regulation of NADPH oxidase, oxidative stress production and overexpression of key inflammatory mediators. These events are associated with up-regulation of AT1R, as evidenced by their reversal with AT1R blocker treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Renal Denervation Using an Irrigated Catheter in Patients with Resistant Hypertension: A Promising Strategy?

    Energy Technology Data Exchange (ETDEWEB)

    Armaganijan, Luciana, E-mail: luciana-va@hotmail.com; Staico, Rodolfo; Moraes, Aline; Abizaid, Alexandre; Moreira, Dalmo; Amodeo, Celso; Sousa, Márcio; Borelli, Flávio; Armaganijan, Dikran; Sousa, J. Eduardo; Sousa, Amanda [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2014-04-15

    Systemic hypertension is an important public health problem and a significant cause of cardiovascular mortality. Its high prevalence and the low rates of blood pressure control have resulted in the search for alternative therapeutic strategies. Percutaneous renal sympathetic denervation emerged as a perspective in the treatment of patients with resistant hypertension. To evaluate the feasibility and safety of renal denervation using an irrigated catheter. Ten patients with resistant hypertension underwent the procedure. The primary endpoint was safety, as assessed by periprocedural adverse events, renal function and renal vascular abnormalities at 6 months. The secondary endpoints were changes in blood pressure levels (office and ambulatory monitoring) and in the number of antihypertensive drugs at 6 months. The mean age was 47.3 (± 12) years, and 90% of patients were women. In the first case, renal artery dissection occurred as a result of trauma due to the long sheath; no further cases were observed after technical adjustments, thus showing an effect of the learning curve. No cases of thrombosis/renal infarction or death were reported. Elevation of serum creatinine levels was not observed during follow-up. At 6 months, one case of significant renal artery stenosis with no clinical consequences was diagnosed. Renal denervation reduced office blood pressure levels by 14.6/6.6 mmHg, on average (p = 0.4 both for systolic and diastolic blood pressure). Blood pressure levels on ambulatory monitoring decreased by 28/17.6 mmHg (p = 0.02 and p = 0.07 for systolic and diastolic blood pressure, respectively). A mean reduction of 2.1 antihypertensive drugs was observed. Renal denervation is feasible and safe in the treatment of resistant systemic arterial hypertension. Larger studies are required to confirm our findings.

  18. Renal effects of hyperinsulinaemia in subjects with two hypertensive parents

    DEFF Research Database (Denmark)

    Andersen, U B; Skøtt, P; Bruun, N E

    1999-01-01

    aged 18-35 years whose parents both had essential hypertension, and 22 age- and sex-matched subjects whose parents were both normotensive. Diabetes or morbid obesity in any subject or parent excluded the family. The 24-h blood pressure was measured. The subjects received an isocaloric diet with a fixed...... the sodium-retaining effect of insulin was more pronounced in subjects with a strong genetic predisposition to essential hypertension than in subjects with normotensive parents. This effect may contribute to the development of hypertension in subjects with a genetic predisposition to hypertension....

  19. Renal denervation attenuates NADPH oxidase-mediated oxidative stress and hypertension in rats with hydronephrosis

    DEFF Research Database (Denmark)

    Peleli, Maria; Al-Mashhadi, Ammar; Yang, Ting

    2016-01-01

    ) regulation in the development of hypertension in rats with hydronephrosis. Hydronephrosis was induced by partial unilateral ureteral obstruction (PUUO) in young rats. Sham surgery or renal denervation was performed at the same time. Blood pressure was measured during normal, high and low salt diets. Renal......Hydronephrosis is associated with development of salt-sensitive hypertension. Studies suggest that increased sympathetic nerve activity (SNA) and oxidative stress play important roles in renovascular hypertension. This study aimed to investigate the link between renal SNA and NADPH oxidase (NOX...... excretion pattern, NOX activity and expression, as well as components of RAAS were characterized. On normal salt diet, PUUO rats had elevated blood pressure compared with controls (115±3 vs 87±1 mmHg), and displayed increased urine production and lower urine osmolality. Blood pressure change in response...

  20. Renal Denervation for Treating Resistant Hypertension: Current Evidence and Future Insights from a Global Perspective

    Directory of Open Access Journals (Sweden)

    Y. Castro Torres

    2013-01-01

    Full Text Available Adequate blood pressure control represents an important goal for all physicians due to the complications of hypertension which reduce patients' quality of life. A new interventional strategy to reduce blood pressure has been developed for patients with resistant hypertension. Catheter-based renal denervation has demonstrated excellent results in recent investigations associated with few side effects. With the growing diffusion of this technique worldwide, some medical societies have published consensus statements to guide physicians how to best apply this procedure. Questions remain to be answered such as the long-term durability of renal denervation, the efficacy in patients with other sympathetically mediated diseases, and whether renal denervation would benefit patients with stage 1 hypertension.

  1. Renal arteriolar injury by salt intake contributes to salt memory for the development of hypertension.

    Science.gov (United States)

    Oguchi, Hideyo; Sasamura, Hiroyuki; Shinoda, Kazunobu; Morita, Shinya; Kono, Hidaka; Nakagawa, Ken; Ishiguro, Kimiko; Hayashi, Kaori; Nakamura, Mari; Azegami, Tatsuhiko; Oya, Mototsugu; Itoh, Hiroshi

    2014-10-01

    The role of salt intake in the development of hypertension is prominent, but its mechanism has not been fully elucidated. Our aim was to examine the effect of transient salt intake during the prehypertensive period in hypertensive model animals. Dahl salt-sensitive rats and spontaneously hypertensive rats were fed from 6 to 14 weeks with low-salt (0.12% NaCl), normal-salt (0.8% NaCl), high-salt (7% NaCl), or high-sodium/normal-chloride diet and returned to normal-salt diet for 3 months. Rats in the high-salt group saw elevations in blood pressure (BP) not only during the treatment period but also for the 3 months after returning to normal-salt diet. We named this phenomenon salt memory. Renal arteriolar injury was found in the high-salt group at the end of experiment. Dahl salt-sensitive rats were fed from 6 to 14 weeks with high-salt diet with angiotensin receptor blocker, vasodilator, calcium channel blocker, and calcium channel blocker+angiotensin receptor blocker and returned to normal-salt diet. Although BP was suppressed to control levels by vasodilator or calcium channel blocker, elevated renal angiotensin II and renal arteriolar injury were observed, and salt memory did not disappear because of sustained renal arteriolar injury. Calcium channel blocker+angiotensin receptor blocker suppressed renal arteriolar injury, resulting in the disappearance of salt memory. Cross-transplantation of kidneys from Dahl salt-sensitive rats on high salt to control rats caused increase of BP, whereas control kidneys caused reduction in BP of hypertensive rats, inducing the central role of the kidney. These results suggest that renal arteriolar injury through BP and renal angiotensin II elevation plays important roles in the development of salt memory for hypertension. © 2014 American Heart Association, Inc.

  2. Thrombotic microangiopathy with hypertension and acute renal failure in children (a typical hemolytic uremic syndrome.

    Directory of Open Access Journals (Sweden)

    Bhuyan U

    1994-07-01

    Full Text Available Thus I would like to conclude by saying that an idiopathic form of obliterative renal arteriopathy account for the rare presentation of severe hypertension and progressive renal failure with or without overt hemolytic anemia and thrombocytopenia in children. It can be labelled as primary malignant nephrosclerosis (NScl or atypical HUS, based on primary thrombotic angiopathy. This, essentially intimal changes, is seen in diverse conditions and appears to result from primary endothelial injury followed by intimal exudation, thrombosis, and repair by fibrosis. Persistent or recurrence of this process form the basis of progressive obliterative arteriopathy. The result is renal ischemia and renin-angiotensin mediated hypertension. Establishment of a vicious circle would further accelerate HT and lead to end stage renal failure. Early recognition and prompt therapeutic intervention might prove beneficial.

  3. Revision on Renal Sympathetic Ablation in the Treatment of Resistant Hypertension.

    Science.gov (United States)

    Saraiva, Ana Filipa

    2016-01-01

    Hypertension is one of the most prevalent diseases in the world, with about 1 billion people affected and a possible increase to 1.5 billion by 2025. Despite advances in treatment, a proportion of patients remain resistant to conventional treatment and uncontrolled, and this can adversely affect future cardiovascular events and mortality. This alarming growth is already reflected in an important public health problem and one of the largest economic burdens of health, requiring new approaches and development of different strategies to fight this problem. This review will focus on the definition of resistant hypertension and its etiology, as well as in contemporary evidence supporting the usefulness of renal sympathetic denervation while addressing current and emerging devices, potential treatment indications in the future and unresolved issues that need to be addressed before renal sympathetic denervation can be adopted not only as a last resort exclusively for resistant hypertension. Finally an evaluation algorithm for patients with resistant hypertension which should be implemented before the execution of this technique will be proposed. Renal sympathetic denervation is a technique that possibly could have future implications in the population with hypertension, especially those with true resistant hypertension. This technique aims to reduce the renal sympathetic activation (a component in the pathophysiology of hypertension) through the destruction of the renal sympathetic nerves located in the adventitia of the renal arteries. There are several catheters that can be used; each with its specifications and therefore their selection should be made individually depending on the profile of the patient. However, a detailed pre-procedure evaluation is extremely important to exclude the large percentage of individuals with uncontrolled hypertension due to several factors that make it impossible to control blood pressure, but are likely to be corrected and as such should

  4. Renal denervation attenuates hypertension and renal dysfunction in a model of cardiovascular and renal disease, which is associated with reduced NADPH and xanthine oxidase activity.

    Science.gov (United States)

    Peleli, Maria; Flacker, Peter; Zhuge, Zhengbing; Gomez, Cristina; Wheelock, Craig E; Persson, A Erik G; Carlstrom, Mattias

    2017-10-01

    Oxidative stress is considered a central pathophysiological event in cardiovascular disease, including hypertension. Early age reduction in renal mass is associated with hypertension and oxidative stress in later life, which is aggravated by increased salt intake. The aim of the present study was to examine if renal sympathetic denervation can exert blood pressure lowering effects in uninephrectomized (UNX) rats (3-week old) fed with high salt (HS, 4%; w/w) diet for 4 weeks. Moreover, we investigated if renal denervation is associated with changes in NADPH and xanthine oxidase-derived reactive oxygen species. Rats with UNX + HS had reduced renal function, elevated systolic and diastolic arterial pressures, which was accompanied by increased heart weight, and cardiac superoxide production compared to sham operated Controls. UNX + HS was also associated with higher expression and activity of NADPH and xanthine oxidase in the kidney. Renal denervation in rats with UNX + HS attenuated the development of hypertension and cardiac hypertrophy, but also improved glomerular filtration rate and reduced proteinuria. Mechanistically, renal denervation was associated with lower expression and activity of both NADPH oxidase and xanthine oxidase in the kidney, but also reduced superoxide production in the heart. In conclusion, our study shows for the first time that renal denervation has anti-hypertensive, cardio- and reno-protective effects in the UNX + HS model, which can be associated with decreased NADPH oxidase- and xanthine oxidase-derived reactive oxygen species (i.e., superoxide and hydrogen peroxide) in the kidney. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Hypertension associated with massive, bilateral, posture-dependent renal dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Clorius, J.H.; Schmidlin, P.; Raptou, E.; Huber, W.; Georgi, P.

    1981-07-01

    Hippurate function scintiscans were obtained in prone and standing positions in a group of 76 patients with concurrent hypertension and nephroptosis. Twelve of these patients had massive, bilateral disturbance of intrarenal hippurate transport in the standing position; hippurate transport was normal in the prone position. This pattern was present in only three of 120 normotensive patients with nephroptosis. To investigate the importance of nephroptosis, 87 other hypertensive patients were examined. Eighteen of these patients demonstrated posture-dependent tubular dysfunction, but only four had nephroptosis. The results suggest a direct relationship between bilateral posture-dependent tubular dysfunction and hypertension.

  6. Atherosclerotic ischemic renal disease. Diagnosis and prevalence in an hypertensive and/or uremic elderly population

    Directory of Open Access Journals (Sweden)

    Rossi Michele

    2003-02-01

    Full Text Available Abstract Background Atherosclerotic ischemic renal disease is a frequent cause of end-stage renal failure leading to dialysis among the elderly; Its prevalence is inferred from autopsy or retrospective arteriographic studies. This study has been conducted on 269 subjects over 50 with hypertension and/or CRF, unrelated to other known causes of renal disease. Methods All 269 patients were studied either by color-flow duplex sonography (n = 238 or by renal scintigraphy (n = 224, and 199 of the 269 patients were evaluated using both of these techniques. 40 patients, found to have renal artery stenosis (RAS, were subjected to 3D-contrast enhancement Magnetic Resonance Angiography (MRA and/or Selective Angiography (SA. An additional 23 cases, negative both to scintigraphy and to ultrasound study, underwent renal angiography (MRA and/or SA. Results Color-duplex sonography, carried out in 238 patients, revealed 49 cases of RAS. MR or SA was carried out in 35 of these 49 patients, and confirmed the diagnosis in 33. Color-duplex sonography showed a PPV value of 94.3% and NPV of 87.0% while renal scintigraphy, carried out in 224 patients, had a PPV of 72.2% and a NPV of 29.4%. Patients with RAS showed a higher degree of renal insufficiency compared to non stenotic patients while there were no differences in proteinuria. RAS, based on color-duplex sonography studies, was present in 11% of patients in the age group 50–59, 18% in the 60–69 and 23% at age 70 and above. Conclusions A relatively large percentage of the elderly population with renal insufficiency and/or hypertension is affected by RAS and is at risk of developing end-stage renal failure. Color-duplex ultrasonography is a valid routine method of investigation of population at risk for renal artery stenosis.

  7. Renal sodium handling and haemodynamics are equally affected by hyperinsulinaemia in salt-sensitive and salt-resistant hypertensives

    NARCIS (Netherlands)

    ter Maaten, JC; Bakker, SJL; Serne, EH; Donker, AJM; Gans, ROB

    Objective It is well-known that insulin induces renal sodium retention. It is not yet known whether insulin's renal effects are involved in the development of salt-sensitive hypertension. We assessed the effects of insulin on renal sodium handling and haemodynamics in 10 salt-sensitive (SS) and 10

  8. Alpha-adducin Gly460Trp polymorphism and renal hemodynamics in essential hypertension

    NARCIS (Netherlands)

    Beeks, Esther; van der Klauw, Melanie M; Kroon, Abraham A; Spiering, Wilko; Fuss-Lejeune, Monique J M J; de Leeuw, Peter W

    2004-01-01

    Previous studies have shown an association between the alpha-adducin Gly460Trp polymorphism and salt-sensitive hypertension. Not much is known about the effects of the variants of this polymorphism on renal hemodynamics and function. Therefore, we performed the present study to investigate the

  9. T-cells contribute to hypertension but not to renal injury in mice with subtotal nephrectomy

    NARCIS (Netherlands)

    Oosterhuis, Nynke R.; Papazova, Diana A.; Gremmels, Hendrik; Joles, Jaap A.; Verhaar, Marianne C.

    2017-01-01

    Background: The pathological condition of chronic kidney disease may not be adequately recapitulated in immunocompromised mice due to the lack of T-cells, which are important for the development of hypertension and renal injury. We studied the role of the immune system in relation to salt-sensitive

  10. Glucocorticoids and renal Na+ transport: implications for hypertension and salt sensitivity

    Science.gov (United States)

    Hunter, Robert W; Ivy, Jessica R; Bailey, Matthew A

    2014-01-01

    The clinical manifestations of glucocorticoid excess include central obesity, hyperglycaemia, dyslipidaemia, electrolyte abnormalities and hypertension. A century on from Cushing's original case study, these cardinal features are prevalent in industrialized nations. Hypertension is the major modifiable risk factor for cardiovascular and renal disease and reflects underlying abnormalities of Na+ homeostasis. Aldosterone is a master regulator of renal Na+ transport but here we argue that glucocorticoids are also influential, particularly during moderate excess. The hypothalamic–pituitary–adrenal axis can affect renal Na+ homeostasis on multiple levels, systemically by increasing mineralocorticoid synthesis and locally by actions on both the mineralocorticoid and glucocorticoid receptors, both of which are expressed in the kidney. The kidney also expresses both of the 11β-hydroxysteroid dehydrogenase (11βHSD) enzymes. The intrarenal generation of active glucocorticoid by 11βHSD1 stimulates Na+ reabsorption; failure to downregulate the enzyme during adaption to high dietary salt causes salt-sensitive hypertension. The deactivation of glucocorticoid by 11βHSD2 underpins the regulatory dominance for Na+ transport of mineralocorticoids and defines the ‘aldosterone-sensitive distal nephron’. In summary, glucocorticoids can stimulate renal transport processes conventionally attributed to the renin–angiotensin–aldosterone system. Importantly, Na+ and volume homeostasis do not exert negative feedback on the hypothalamic–pituitary–adrenal axis. These actions are therefore clinically relevant and may contribute to the pathogenesis of hypertension in conditions associated with elevated glucocorticoid levels, such as the metabolic syndrome and chronic stress. PMID:24535442

  11. Hypertension and renal toxicity during angiogenesis inhibition : Salt dependency and treatment options

    NARCIS (Netherlands)

    S. Lankhorst (Stephanie)

    2016-01-01

    markdownabstractAbstract Angiogenesis inhibition, by targeting VEGF or its receptors, has become an established treatment for various tumor types but is associated with adverse effects including hypertension, proteinuria and renal injury with activation of the endothelin-1 system. Sunitinib is

  12. Caffeine intake antagonizes salt sensitive hypertension through improvement of renal sodium handling.

    Science.gov (United States)

    Yu, Hao; Yang, Tao; Gao, Peng; Wei, Xing; Zhang, Hexuan; Xiong, Shiqiang; Lu, Zongshi; Li, Li; Wei, Xiao; Chen, Jing; Zhao, Yu; Arendshorst, William J; Shang, Qianhui; Liu, Daoyan; Zhu, Zhiming

    2016-05-12

    High salt intake is a major risk factor for hypertension. Although acute caffeine intake produces moderate diuresis and natriuresis, caffeine increases the blood pressure (BP) through activating sympathetic activity. However, the long-term effects of caffeine on urinary sodium excretion and blood pressure are rarely investigated. Here, we investigated whether chronic caffeine administration antagonizes salt sensitive hypertension by promoting urinary sodium excretion. Dahl salt-sensitive (Dahl-S) rats were fed with high salt diet with or without 0.1% caffeine in drinking water for 15 days. The BP, heart rate and locomotor activity of rats was analyzed and urinary sodium excretion was determined. The renal epithelial Na(+) channel (ENaC) expression and function were measured by in vivo and in vitro experiments. Chronic consumption of caffeine attenuates hypertension induced by high salt without affecting sympathetic nerve activity in Dahl-S rats. The renal α-ENaC expression and ENaC activity of rats decreased after chronic caffeine administration. Caffeine increased phosphorylation of AMPK and decrease α-ENaC expression in cortical collecting duct cells. Inhibiting AMPK abolished the effect of caffeine on α-ENaC. Chronic caffeine intake prevented the development of salt-sensitive hypertension through promoting urinary sodium excretion, which was associated with activation of renal AMPK and inhibition of renal tubular ENaC.

  13. Catheter-Based Renal Nerve Ablation and Centrally Generated Sympathetic Activity in Difficult-to-Control Hypertensive Patients: Prospective Case Series

    NARCIS (Netherlands)

    Brinkmann, J.; Heusser, K.; Schmidt, B.M.; Menne, J.; Klein, G.; Bauersachs, J.; Haller, H.; Sweep, F.C.; Diedrich, A.; Jordan, J.; Tank, J.

    2012-01-01

    Endovascular renal nerve ablation has been developed to treat resistant hypertension. In addition to lowering efferent renal sympathetic activation, the intervention may attenuate central sympathetic outflow through decreased renal afferent nerve traffic, as evidenced by a recent case report. We

  14. Effects of aging and uninephrectomy on renal changes in Tsukuba hypertensive mice.

    Science.gov (United States)

    Inui, Yosuke; Mochida, Hideki; Yamairi, Fumiko; Okada, Miyoko; Ishida, Junji; Fukamizu, Akiyoshi; Arakawa, Kenji

    2013-05-01

    Renal dysfunction is accelerated by various factors such as hypertension, aging and diabetes. Glomerular hyper-filtration, considered one of the major risk factors leading to diabetic nephropathy, is often encountered in diabetic patients. However, the interrelationship of these risk factors during the course and development of renal dysfunction has not been fully elucidated. In this study, the effects of aging and uninephrectomy (UNx)-induced hyperfiltration on renal changes were investigated in Tsukuba hypertensive mice (THM) carrying both human renin and angiotensinogen genes. In THM, the urinary albumin/creatinine (Alb/Cr) ratio was elevated with age without a concomitant increase in the plasma Cr concentration. Moreover, the urinary neutrophil gelatinase-associated lipocalin/Cr (NGAL/Cr) ratio, the renal monocyte chemoattractant protein-1 (MCP-1) mRNA expression and the renal collagen type I α 2 (COL1A2) mRNA expression were also increased with age. Age-related albuminuria in THM is likely caused by renal tubular damage, enhanced inflammatory response and tubulointerstitial fibrosis. Furthermore, following UNx, the urinary Alb/Cr ratio and the plasma Cr concentration were increased in THM. The urinary NGAL/Cr ratio and the renal MCP-1 and COL1A2 mRNA expression were not affected by UNx. These results suggested that UNx-induced albuminuria in THM was caused by glomerular dysfunction, rather than renal tubular injury. In conclusion, this study demonstrated for the first time the effects of aging and UNx on renal changes in THM. These findings strongly reinforce the significance of applying a diversity of therapeutic approaches to the management of renal dysfunction.

  15. Sympathetic nerve traffic and blood pressure changes after bilateral renal denervation in resistant hypertension: a time-integrated analysis.

    Science.gov (United States)

    Seravalle, Gino; D'Arrigo, Graziella; Tripepi, Giovanni; Mallamaci, Francesca; Brambilla, Gianmaria; Mancia, Giuseppe; Grassi, Guido; Zoccali, Carmine

    2017-08-01

    Renal denervation reduces blood pressure (BP) and sympathetic drive in experimental animal models, but the effect of this intervention on sympathetic activity in patients with treatment-resistant hypertension is still unclear. In an incident series of 29 patients with treatment-resistant hypertension, we performed serial measurements (n = 123) of muscle sympathetic nerve activity (MSNA, microneurography) and standardized BP measurements. Data were analysed by mixed linear modelling (MLM) and by regression analysis of time-integrated changes of both MSNA and synchronous, standardized (in-lab) BP measurements. Bilateral renal denervation was accompanied by a marked reduction in MSNA (P = 0.01 by MLM), which was parallelled by a reduction in systolic (from 175 ± 14 to 156 ± 16 mmHg) and, to a lesser extent, in diastolic (from 96 ± 12 to 87 ± 6 mmHg) BP over time. Neither systolic nor diastolic BP associated to a significant extent with corrected MSNA (MSNAC) in the MLM analysis (systolic BP versus MSNAC: β = -0.08, P = 0.08; diastolic BP versus MSNAC: β = -0.007, P = 0.75). However, the study of time-integrated changes in MSNA and BP showed a robust association between proportional changes in MSNA over time and simultaneous changes in systolic and diastolic BP (β = 0.61, P hypertension and in the BP-lowering effect of the procedure.

  16. Angiotensin Type 2 Receptor Stimulation Increases Renal Function in Female, but Not Male, Spontaneously Hypertensive Rats

    DEFF Research Database (Denmark)

    Hilliard, Lucinda M; Chow, Charis L E; Mirabito, Katrina M

    2014-01-01

    in female hypertensive rats (PTreatmentarterial pressure. For example, at 300 ng/kg per minute of compound 21, renal blood flow increased by 14.3±1.8% from baseline. Furthermore, at 300 ng/kg per minute of compound 21, a significant increase in urinary sodium excretion...... vasodilatation and sodium excretion without concomitant alterations in glomerular filtration rate in female hypertensive rats. Chronic studies of AT2R agonist therapy on renal function and arterial pressure in hypertensive states are now required to establish the suitability of AT2R as a therapeutic target......Accumulating evidence suggests that the protective pathways of the renin-angiotensin system are enhanced in women, including the angiotensin type 2 receptor (AT2R), which mediates vasodilatory and natriuretic effects. To provide insight into the sex-specific ability of pharmacological AT2R...

  17. Early Stage of Chronic Kidney Disease with Renal Injury Caused by Hypertension in a Dog

    Directory of Open Access Journals (Sweden)

    Akira Yabuki

    2011-01-01

    Full Text Available A 10-year-old spayed female Papillon weighing 4.0 kg presented with a history of persistent hematuria and pollakiuria. Concurrent bladder calculi, a mammary gland tumor, and nonazotemic early stage of chronic kidney disease with contracted kidneys were noted in this dog. The dog underwent cystectomy, unilateral mastectomy, and intraoperative renal biopsy. On the basis of histopathological analysis of renal biopsy results, it was suspected that renal injury of the dog was caused by persistent hypertension, and a follow-up examination revealed severe hypertension. The dog was treated with a combination of an angiotensin-converting enzyme inhibitor and calcium channel blocker. The treatment produced a good outcome in the dog, and there has been no progression of the chronic kidney disease for over 2 years.

  18. Splanchnic-aortic inflammatory axis in experimental portal hypertension

    Science.gov (United States)

    Aller, Maria-Angeles; de las Heras, Natalia; Nava, Maria-Paz; Regadera, Javier; Arias, Jaime; Lahera, Vicente

    2013-01-01

    Splanchnic and systemic low-grade inflammation has been proposed to be a consequence of long-term prehepatic portal hypertension. This experimental model causes minimal alternations in the liver, thus making a more selective study possible for the pathological changes characteristic of prehepatic portal hypertension. Low-grade splanchnic inflammation after long-term triple partial portal vein ligation could be associated with liver steatosis and portal hypertensive intestinal vasculopathy. In fact, we have previously shown that prehepatic portal hypertension in the rat induces liver steatosis and changes in lipid and carbohydrate metabolism similar to those produced in chronic inflammatory conditions described in metabolic syndrome in humans. Dysbiosis and bacterial translocation in this experimental model suggest the existence of a portal hypertensive intestinal microbiome implicated in both the splanchnic and systemic alterations related to prehepatic portal hypertension. Among the systemic impairments, aortopathy characterized by oxidative stress, increased levels of proinflammatory cytokines and profibrogenic mediators stand out. In this experimental model of long-term triple portal vein ligated-rats, the abdominal aortic proinflammatory response could be attributed to oxidative stress. Thus, the increased aortic reduced-nicotinamide-adenine dinucleotide phosphate [NAD(P)H] oxidase activity could be associated with reactive oxygen species production and promote aortic inflammation. Also, oxidative stress mediated by NAD(P)H oxidase has been associated with risk factors for inflammation and atherosclerosis. The splanchnic and systemic pathology that is produced in the long term after triple partial portal vein ligation in the rat reinforces the validity of this experimental model to study the chronic low-grade inflammatory response induced by prehepatic portal hypertension. PMID:24307792

  19. Arterial scleroproteins in atherosclerosis and hypertension (Experimental studies)

    International Nuclear Information System (INIS)

    Yurukova, Ts.; Georgiev, P.

    1979-01-01

    The authors studied the neosynthesis of fiber protein (scleroproteins) in the aorta of rats with genetic hypertension and with experimental atherosclerosis following application of 3 H-proline and 3 H-lysine and subsequent determination of radioactivity of the collagen and elastic fractions of the aortic wall. There was a great increase in incorporation of labelled collagen and elastin precursors in the aorta of hypertensive and atherosclerotic animals, in comparison with the control rats - a manifestation of incresed ''de novo'' synthesis of fiber proteins in rats with these arterial diseases. Furthermore, the increased collagenosis dominated over that of elastogenesis. The irregular activation of the biosynthesis of both scleroproteins in hypertensive rats and in rats with atherosclerosis caused remodelling of the macromolecular structure of the arterial wall with predominance of collagen over the remaining hypertension components and progression of atherosclerosis. (author) (author)

  20. Renal denervation attenuates hypertension but not salt sensitivity in ETBreceptor-deficient rats.

    Science.gov (United States)

    Becker, Bryan K; Feagans, Amanda C; Chen, Daian; Kasztan, Malgorzata; Jin, Chunhua; Speed, Joshua S; Pollock, Jennifer S; Pollock, David M

    2017-10-01

    Hypertension is a prevalent pathology that increases risk for numerous cardiovascular diseases. Because the etiology of hypertension varies across patients, specific and effective therapeutic approaches are needed. The role of renal sympathetic nerves is established in numerous forms of hypertension, but their contribution to salt sensitivity and interaction with factors such as endothelin-1 are poorly understood. Rats deficient of functional ET B receptors (ET B -def) on all tissues except sympathetic nerves are hypertensive and exhibit salt-sensitive increases in blood pressure. We hypothesized that renal sympathetic nerves contribute to hypertension and salt sensitivity in ET B -def rats. The hypothesis was tested through bilateral renal sympathetic nerve denervation and measuring blood pressure during normal salt (0.49% NaCl) and high-salt (4.0% NaCl) diets. Denervation reduced mean arterial pressure in ET B -def rats compared with sham-operated controls by 12 ± 3 (SE) mmHg; however, denervation did not affect the increase in blood pressure after 2 wk of high-salt diet (+19 ± 3 vs. +16 ± 3 mmHg relative to normal salt diet; denervated vs. sham, respectively). Denervation reduced cardiac sympathetic-to-parasympathetic tone [low frequency-high frequency (LF/HF)] during normal salt diet and vasomotor LF/HF tone during high-salt diet in ET B -def rats. We conclude that the renal sympathetic nerves contribute to the hypertension but not to salt sensitivity of ET B -def rats. Copyright © 2017 the American Physiological Society.

  1. Relationship between arterial hypertension and renal damage in chronic kidney disease: insights from ABPM.

    Science.gov (United States)

    Paoletti, Ernesto; Bellino, Diego; Amidone, Marco; Rolla, Davide; Cannella, Giuseppe

    2006-01-01

    To date, few studies have used ambulatory pressure monitoring (ABPM) in patients with chronic kidney disease (CKD) before the start of dialysis treatment. The aim of this study was therefore to ascertain the correlates of arterial hypertension assessed by ABPM in CKD patients at their first referral to a nephrologist. We studied 244 (164 men; mean age 63 years) nondiabetic patients with CKD. Each patient had blood pres-sure (BP) measured by 24-hour ABPM, creatinine clearance (CrCl) estimated according to the Cockcroft-Gault formula, and Hgb concentration, serum lipids, iPTH, daily urinary protein (Uprot) and sodium (UNa) excretion assessed using routine methods. According to ABPM data analysis, 81 patients were normotensives, 78 were stable hypertensives, 26 had day-time hypertension and 59 had nocturnal hypertension. ANOVA showed both lower CrCl (p=0.0033), and higher Uprot (p nighttime SBP > 24-hour PP > daytime PP > daytime SBP > 24-hour SBP. In CKD patients, proteinuria is the strongest correlate of arterial hypertension and particularly of increased nocturnal PP, possibly as an expression of vascular damage. On the basis of these results, ABPM appears to be the most reliable tool for detecting the associations between raised BP (particularly nighttime hypertension) and renal damage in CKD patients not yet on renal replacement therapy (RRT).

  2. [Renal denervation for the treatment of resistant hypertension: definition, patient selection and description of the procedure. 2012 Position paper of the Italian Society of Hypertension].

    Science.gov (United States)

    Volpe, Massimo; Agabiti-Rosei, Enrico; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Mancia, Giuseppe; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Tocci, Giuliano; Virdis, Agostino

    2012-12-01

    Hypertension is responsible for a relevant burden of cardiovascular morbidity and mortality worldwide. Although several appropriate and integrated pharmacological strategies are available, blood pressure control still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on overall cardiovascular risk, since it significantly increases the risk of both macrovascular and microvascular complications. Hypertension is arbitrarily defined as "resistant" or "refractory" when recommended blood pressure goals (clinic blood pressure hypertension has recently become available. Renal sympathetic denervation is a minimally invasive procedure performed via femoral access that uses radiofrequency catheter ablation to disable renal sympathetic afferent and efferent nerves. It results in isolation of renal parenchymal and juxtaglomerular cells from the abnormal enhancement of renal adrenergic nerve activity. The present position paper of the Italian Society of Hypertension provides a diagnostic and therapeutic approach to the early identification and effective clinical management of patients with resistant hypertension, who may be candidates for renal denervation. These indications may have important implications not only from a clinical viewpoint but also from an economic perspective. The accurate identification of patients with resistant hypertension and the appropriate selection of patients eligible for this procedure may help improve blood pressure control and reduce the risk of cardiovascular and cerebrovascular complications in these patients.

  3. Glomerular Damage in Experimental Proliferative Glomerulonephritis Under Glomerular Capillary Hypertension

    Directory of Open Access Journals (Sweden)

    Pei-Rong Wang

    2015-03-01

    Full Text Available Background/Aims: Immunologically and hemodynamically mediated the destruction of glomerular architecture is thought to be the major causes of end-stage renal failure. The purpose of this study is to evaluate the effect of glomerular hypertension on glomerular injury and the progression of glomerular sclerosis after Thy-1 nephritis was induced. Method: Thy-1 nephritis was induced in the stroke-prone spontaneously hypertensive rat strain (SHR-SP (group SP and in age-matched Wistar-Kyoto (WKY (group WKY rats, following unilateral nephrectomy (UNX, and a vehicle was injected alone in UNX SHR-SP as control (group SC. Result: The degree of glomerular damage in response to a single dose of anti-thy-1 antibody, and its functional consequences (eg. proteinuria, diminished GFR are more pronounced in group SP than normotensive group WKY and hypertensive group SC without mesangial cell injury. While normotensive group WKY rats recovered completely from mesangial cell injury on day 28-42, glomeruli in group SP kept on persistent macrophage infiltration, α-SMA expression on day 42-56. In addition, glomerular capillary repair with the GECs was rarely seen in pronouncedly proliferative and sclerostic areas. The incidence of glomerular sclerosis and the level of proteinuria were markedly increased by day 56 in the group SP. Conclusions: Our results demonstrate that glomerular hypertension aggravate glomerular damage and glomerulosclerosis in this model of Thy 1 nephritis.

  4. Improved interpretation of renal-vein-renin-ratio by simultaneous determination of renal 131I-hippuric-acid-clearance-ratio in patients with renovascular hypertension

    International Nuclear Information System (INIS)

    Helber, A.; Boenner, G.; Hummerich, W.; Wambach, G.; Meurer, K.A.; Dvorak, K.; Lent, V.; Zehle, A.; Kaufmann, W.; Koeln Univ.; Staedtisches Krankenhaus Koeln-Merheim; Staedtisches Krankenhaus Koeln-Merheim; Koeln Univ.

    1979-01-01

    In patients with unilateral vascular kidney disease and hypertension, ratio of renal-vein-renin was compared with 131 I-Hippuric-acid clearance and change in blood pressure during Saralasininfusion. The ratio of renal-vein-renin was positively correlated with the ratio in renal plasma flow between the kidneys in all patients studied. The ratio of renins therefore is a result of two factors: The difference in renin secretion and the difference in blood flow in the two kidneys. In patients with angiotensin independent hypertension renin-ratios up to 2.0 were found without relevance to elevated blood pressure. When the difference in renal blood flow between both kidneys was small, even a slight difference in renal vein renin indicated hypertension related to increased renin secretion. (orig./AJ) [de

  5. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Sirinelli, D.; Schmit, P.; Biriotti, V.; Bensman, A.; Lupold, M.

    1987-02-01

    During antibiotic treatment for E.coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abcess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal.

  6. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    International Nuclear Information System (INIS)

    Sirinelli, D.; Schmit, P.; Biriotti, V.; Bensman, A.; Lupold, M.

    1987-01-01

    During antibiotic treatment for E.coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abcess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal. (orig.)

  7. Hypertension, end-stage renal disease and mesangiocapillary ...

    African Journals Online (AJOL)

    Background: Methamphetamine abuse has risen dramatically in South Africa. The chronic effects of abuse on the kidneys and blood pressure have not been documented. This study reviewed patients referred for evaluation of kidney disease and/or hypertension, who had been abusing methamphetamines. Methods: The ...

  8. Pulmonary Hypertension Among End-Stage Renal Failure Patients Following Hemodialysis Access Thrombectomy

    International Nuclear Information System (INIS)

    Harp, Richard J.; Stavropoulos, S. William; Wasserstein, Alan G.; Clark, Timothy W.I.

    2005-01-01

    Purpose: Percutaneous hemodialysis thrombectomy causes subclinical pulmonary emboli without short-term clinical consequence; the long-term effects on the pulmonary arterial vasculature are unknown. We compared the prevalence of pulmonary hypertension between patients who underwent one or more hemodialysis access thrombectomy procedures with controls without prior thrombectomy.Methods: A retrospective case-control study was performed. Cases (n = 88) had undergone one or more hemodialysis graft thrombectomy procedures, with subsequent echocardiography during routine investigation of comorbid cardiovascular disease. Cases were compared with controls without end-stage renal disease (ESRD) (n = 100, group 1), and controls with ESRD but no prior thrombectomy procedures (n = 117, group 2). The presence and velocity of tricuspid regurgitation on echocardiography was used to determine the prevalence and grade of pulmonary hypertension; these were compared between cases and controls using the chi-square test and logistic regression.Results: The prevalence of pulmonary hypertension among cases was 52% (46/88), consisting of mild, moderate and severe in 26% (n = 23), 10% (n = 9) and 16% (n = 14), respectively. Prevalence of pulmonary hypertension among group 1 controls was 26% (26/100), consisting of mild, moderate and severe pulmonary hypertension in 14%, 5% and 7%, respectively. Cases had 2.7 times greater odds of having pulmonary hypertension than group 1 controls (p = 0.002). The prevalence of pulmonary hypertension among group 2 controls was 42% (49/117), consisting of mild, moderate and severe pulmonary arterial hypertension in 25% (n = 49), 10% (n = 12) and 4% (n = 5), respectively. Cases were slightly more likely to have pulmonary hypertension than group 2 controls (OR = 1.5), although this failed to reach statistical significance (p = 0.14).Conclusion: Prior hemodialysis access thrombectomy does not appear to be a risk factor for pulmonary arterial hypertension

  9. Kidney Disease and Perinatal Programming of Arterial Hypertension: the Results of Experimental Researches

    Directory of Open Access Journals (Sweden)

    Olga P. Kovtun

    2017-01-01

    Full Text Available Deterioration of development conditions in the perinatal period (starvation of the mother, excess sodium ions in her diet, exposure to glucocorticosteroids, placental insufficiency programs significant  changes in the excretion of sodium ions in the newborn and leads to the development of hypertension. Studies on experimental animals show  that unfavourable conditions of intrauterine development can reduce the effective area of glomerular filtration and its rate. These circumstances  increase the expression of membrane carriers of sodium ions in the  apical membranes, the production of superoxide radicals and enhance  the reabsorption of sodium. The article discusses the potential mechanisms of perinatal programming of renal hypertension in humans.

  10. Impact of renal function on cardiovascular events in elderly hypertensive patients treated with efonidipine.

    Science.gov (United States)

    Hayashi, Koichi; Saruta, Takao; Goto, Yoshio; Ishii, Masao

    2010-11-01

    This study evaluated the impact of renal function on cardiovascular outcomes in elderly hypertensive patients enrolled in the Japanese Trial to Assess Optimal Systolic Blood Pressure in Elderly Hypertensive patients. The patients were randomly assigned to either a strict-treatment group (target systolic blood pressure (BP) stroke, cardiovascular disease and renal disease) were evaluated during the 2-year follow-up period following the prospective randomized open-blinded end-point method. Estimated glomerular filtration rate (eGFR) was elevated throughout the trial period in both the strict-treatment (59.4-62 ml min⁻¹ per 1.73 m²) and the mild-treatment group (58.8-61.4 ml min⁻¹ per 1.73 m²). This tendency was also observed in diabetic patients and patients aged ≥75 years, with baseline eGFRrelationship with the incidence of cardiovascular events, nor did the level of BP control. Proteinuria at the time of entry into the study, however, was significantly correlated with cardiovascular event rates (7.1%), an association that was more apparent in patients with eGFRfunction and proteinuria constitute critical risk factors for cardiovascular events in elderly hypertensive patients, trends that are enhanced when baseline eGFR is diminished. Furthermore, the fact that efonidipine-based regimens ameliorate renal function in elderly hypertensive patients with chronic kidney disease may offer novel information on the mechanisms of cardiovascular protection.

  11. The effect of renal denervation in an experimental model of chronic renal insufficiency, The REmnant kidney Denervation In Pigs study (REDIP study

    Directory of Open Access Journals (Sweden)

    Jean-Claude Lubanda

    2017-10-01

    Full Text Available Abstract Background Renal denervation (RDN is a promising therapeutic method in cardiology. Its currently most investigated indication is resistant hypertension. Other potential indications are atrial fibrillation, type 2 diabetes mellitus and chronic renal insufficiency among others. Previous trials showed conflicting but promising results, but the real benefits of RDN are still under investigation. Patients with renal insufficiency and resistant hypertension are proposed to be a good target for this therapy due to excessive activation of renal sympathetic drive. However, only limited number of studies showed benefits for these patients. We hypothesize that in our experimental model of chronic kidney disease (CKD due to ischemia with increased activity of the renin–angiotensin–aldosterone system (RAAS, renal denervation can have protective effects by slowing or blocking the progression of renal injury. Methods An experimental biomodel of chronic renal insufficiency induced by ischemia was developed using selective renal artery embolization (remnant kidney porcine model. 27 biomodels were assessed. Renal denervation was performed in 19 biomodels (denervated group, and the remaining were used as controls (n = 8. The extent of renal injury and reparative process between the two groups were compared and assessed using biochemical parameters and histological findings. Results Viable remnant kidney biomodels were achieved and maintained in 27 swine. There were no significant differences in biochemical parameters between the two groups at baseline. Histological assessment proved successful RDN procedure in all biomodels in the denervated group. Over the 7-week period, there were significant increases in serum urea, creatinine, and aldosterone concentration in both groups. The difference in urea and creatinine levels were not statistically significant between the two groups. However, the level of aldosterone in the denervated was significantly

  12. The effect of renal denervation in an experimental model of chronic renal insufficiency, The REmnant kidney Denervation In Pigs study (REDIP study).

    Science.gov (United States)

    Lubanda, Jean-Claude; Chochola, Miroslav; Mlček, Mikuláš; Neužil, Petr; Marek, Josef; Havránek, Štěpán; Kuchynková, Sylvie; Fingrová, Zdeňka; Huang, Kao-Hsuan Aimee; Linhart, Aleš

    2017-10-25

    Renal denervation (RDN) is a promising therapeutic method in cardiology. Its currently most investigated indication is resistant hypertension. Other potential indications are atrial fibrillation, type 2 diabetes mellitus and chronic renal insufficiency among others. Previous trials showed conflicting but promising results, but the real benefits of RDN are still under investigation. Patients with renal insufficiency and resistant hypertension are proposed to be a good target for this therapy due to excessive activation of renal sympathetic drive. However, only limited number of studies showed benefits for these patients. We hypothesize that in our experimental model of chronic kidney disease (CKD) due to ischemia with increased activity of the renin-angiotensin-aldosterone system (RAAS), renal denervation can have protective effects by slowing or blocking the progression of renal injury. An experimental biomodel of chronic renal insufficiency induced by ischemia was developed using selective renal artery embolization (remnant kidney porcine model). 27 biomodels were assessed. Renal denervation was performed in 19 biomodels (denervated group), and the remaining were used as controls (n = 8). The extent of renal injury and reparative process between the two groups were compared and assessed using biochemical parameters and histological findings. Viable remnant kidney biomodels were achieved and maintained in 27 swine. There were no significant differences in biochemical parameters between the two groups at baseline. Histological assessment proved successful RDN procedure in all biomodels in the denervated group. Over the 7-week period, there were significant increases in serum urea, creatinine, and aldosterone concentration in both groups. The difference in urea and creatinine levels were not statistically significant between the two groups. However, the level of aldosterone in the denervated was significantly lower in comparison to the controls. Histological

  13. Evidence that blood pressure remains under the control of arterial baroreceptors in renal hypertensive rats

    Directory of Open Access Journals (Sweden)

    A.S. Trindade Jr.

    2009-10-01

    Full Text Available The purpose of the present study was to determine the range of the influence of the baroreflex on blood pressure in chronic renal hypertensive rats. Supramaximal electrical stimulation of the aortic depressor nerve and section of the baroreceptor nerves (sinoaortic denervation were used to obtain a global analysis of the baroreceptor-sympathetic reflex in normotensive control and in chronic (2 months 1-kidney, 1-clip hypertensive rats. The fall in blood pressure produced by electrical baroreceptor stimulation was greater in renal hypertensive rats than in normotensive controls (right nerve: -47 ± 8 vs -23 ± 4 mmHg; left nerve: -51 ± 7 vs -30 ± 4 mmHg; and both right and left nerves: -50 ± 8 vs -30 ± 4 mmHg; P < 0.05. Furthermore, the increase in blood pressure level produced by baroreceptor denervation in chronic renal hypertensive rats was similar to that observed in control animals 2-5 h (control: 163 ± 5 vs 121 ± 1 mmHg; 1K-1C: 203 ± 7 vs 170 ± 5 mmHg; P < 0.05 and 24 h (control: 149 ± 3 vs 121 ± 1 mmHg; 1K-1C: 198 ± 8 vs 170 ± 5 mmHg; P < 0.05 after sinoaortic denervation. Taken together, these data indicate that the central and peripheral components of the baroreflex are acting efficiently at higher arterial pressure in renal hypertensive rats when the aortic nerve is maximally stimulated or the activity is abolished.

  14. EXERCISE TRAINING IMPROVES CARDIOVASCULAR AUTONOMIC ACTIVITY AND ATTENUATES RENAL DAMAGE IN SPONTANEOUSLY HYPERTENSIVE RATS

    Directory of Open Access Journals (Sweden)

    Octávio Barbosa Neto

    2013-03-01

    Full Text Available Experiments were performed to determine the influence of exercise training by swimming on cardiovascular autonomic control and renal morphology in spontaneously hypertensive rats (SHR and Wystar-Kyoto (WKY rats. Sedentary normotensive (SN, trained normotensive (TN, sedentary hypertensive (SH, and trained hypertensive (TH rats were included in this study. Arterial pressure (AP, heart rate (HR, means of power spectral analysis of HR (HRV and systolic AP variability (SAPV were recorded in baseline conditions. Following, the HR baroreflex and autonomic tonus control were assessed. At the end, all animals were euthanized and their kidneys were excised to evaluate renal damage. Resting bradycardia was observed in TH and TN rats compared with their respective sedentary animals (p < 0.05. Exercise training attenuated AP in TH vs. SH (p < 0.001. The LF component of HRV and SAPV were lower in TH than SH (p < 0.05. The LF/HF relation was lower in TH than SH and SN (p < 0.05. TN and TH rats showed a sympathetic tonus reduction in comparison to SN and SH rats (p < 0.001. The TH presented an increased vagal tonus compared to SH (p < 0.05. Exercise training improved baroreflex control of HR in TH group versus SH (p < 0.05. The TH showed a lower number of sclerotic glomeruli compared to SH (p < 0.005. The exercise training decrease the glomerular indexes in TN and TH (p < 0.05. Further analysis showed a significant correlation between sympathetic nervous activity and AP levels (p < 0.05. A positive association was also found between sympathetic nervous activity and glomerular index (p < 0.05. Therefore, the exercise training reduces AP and attenuates renal damage. In addition, the attenuation of renal injury was associated with lower sympathetic activity. These findings strongly suggest that exercise training may be a therapeutic tool for improving structure and renal function in hypertensive individuals.

  15. Impaired P2X signalling pathways in renal microvascular myocytes in genetic hypertension

    KAUST Repository

    Gordienko, Dmitri V.

    2014-12-16

    Aims P2X receptors (P2XRs) mediate sympathetic control and autoregulation of renal circulation triggering preglomerular vasoconstriction, which protects glomeruli from elevated pressures. Although previous studies established a casual link between glomerular susceptibility to hypertensive injury and decreased preglomerular vascular reactivity to P2XR activation, the mechanisms of attenuation of the P2XR signalling in hypertension remained unknown. We aimed to analyse molecular mechanisms of the impairment of P2XR signalling in renal vascular smooth muscle cells (RVSMCs) in genetic hypertension. Methods and results We compared the expression of pertinent genes and P2XR-linked Ca2+ entry and Ca2+ release mechanisms in RVSMCs of spontaneously hypertensive rats (SHRs) and their normotensive controls, Wistar Kyoto (WKY) rats. We found that, in SHR RVSMCs, P2XR-linked Ca2+ entry and Ca2+ release from the sarcoplasmic reticulum (SR) are both significantly reduced. The former is due to down-regulation of the P2X1 subunit. The latter is caused by a decrease of the SR Ca2+ load. The SR Ca2+ load reduction is caused by attenuated Ca2+ uptake via down-regulated sarco-/endoplasmic reticulum Ca2+-ATPase 2b and elevated Ca2+ leak from the SR via ryanodine receptors (RyRs) and inositol 1,4,5-trisphosphate receptors. Spontaneous activity of these Ca2+-release channels is augmented due to up-regulation of RyR type 2 and elevated IP3 production by up-regulated phospholipase C-β1. Conclusions Our study unravels the cellular and molecular mechanisms of attenuation of P2XR-mediated preglomerular vasoconstriction that elevates glomerular susceptibility to harmful hypertensive pressures. This provides an important impetus towards understanding of the pathology of hypertensive renal injury.

  16. Severe pulmonary hypertension in a young patient with end-stage renal disease on chronic hemodialysis

    International Nuclear Information System (INIS)

    Sharma, Satyavan; Kirpalani, Ashok L; Kulkarni, Amit

    2010-01-01

    Severe pulmonary hypertension in a teenager with end-stage renal disease on chronic hemodialysis via arteriovenous access is reported. Clinical presentation included persistent volume overload and pericardial effusion. Serial hemodynamic data obtained at cardiac catheterization confirmed the diagnosis. In addition, detailed biochemical and imaging data (echo- Doppler, computed tomography of chest, computed tomographic pulmonary angiography, VQ lung scan, etc.) were obtained to find out the mechanism. The exact cause of pulmonary hypertension remains unclear, and a multi- factorial mechanism is postulated. This rare case is presented to highlight the role of aggressive dialysis, pericardiocentesis, and use of sildenafil and bosentan in the management

  17. EXPERIMENTAL AND CLINICAL SIGNIFICANCE OF RENAL FUNCTIONAL RESERVE DETERMINATION

    Directory of Open Access Journals (Sweden)

    Jernej Pajek

    2002-07-01

    Full Text Available Background. Renal functional reserve (RFR is defined as the temporary increase in glomerular filtration rate (GFR which follows the ingestion of proteins or infusion of aminoacids. This renal vasodilatatory response is probably mediated by several mechanisms, with nitric oxide being one of the most important mediators. In the last years significant progress in measuring renal functional reserve has been achieved on the basis of improvements in methods for accurate and timely appropriate GFR measurement. The method of GFR measurement using the sinistrin clearence calculation after bolus injection of sinistrin is increasingly employed.Conclusions. The article presents the latest results of experiments with RFR using this method and compares them with older reports. RFR is affected by several patophysiological processes: arterial hypertension, diabetes mellitus, deteriorating function of transplanted kidney. The results and impact of RFR determination in this conditions are described. Finally, potential for further research of RFR in atherosclerotic vascular disease is considered. Accurate determination of RFR is important for detection of early renal hemodynamic abnormalities, which can be influenced by therapeutic interventions and in this way the progression of renal functional deterioration could be prevented or at least slowed.

  18. Determination and clinical significance of renal filtration fraction in nephrogenic hypertension

    International Nuclear Information System (INIS)

    Karaev, M.Eh.; Figarov, I.G.; Samedov, R.N.; Grigor'ev, O.N.

    1989-01-01

    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 ( 131 I-hippuran and 99m Tc-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

  19. Correlation between evolution and treatment of hypertension in unilateral renal disease and values of renin activity in renal venous blood.

    Science.gov (United States)

    Zech, P; Sassard, J; Pozet, N; Annat, G

    1978-01-01

    93 patients with renal hypertension and renal vein PRA determination were studied during 1--5 years follow-up. They were separated in two groups of medical and surgical treatment. Medical treatment is able to normalize blood pressure even in cases with high asymmetric PRA. 9 of 16 patients could be cured or improved in the surgical group and 14 of 22 in the medical group. The best results were obtained if beta-blockers were included in the drug regimen: cured or improved were 7 of 33 patients in medical treatment without beta-blockers, 17 of 28 in surgical treatment, and 31 of 32 in medical treatment including beta-blockers with or without hydralazine and/or diuretics.

  20. Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report.

    Science.gov (United States)

    Forslund, Terje; Koistinen, Arvo; Anttinen, Jorma; Wagner, Bodo; Miettinen, Marja

    2008-01-01

    We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

  1. Renal denervation using focused infrared fiber lasers: a potential treatment for hypertension.

    Science.gov (United States)

    Alexander, Vinay V; Shi, Zhennan; Iftekher, Fariha; Welsh, Michael J; Gurm, Hitinder S; Rising, Gail; Yanovich, Amber; Walacavage, Kim; Islam, Mohammed N

    2014-11-01

    Renal denervation has recently become of great interest as a potential treatment for resistant hypertension. Denervation techniques using radio frequency (RF) or ultrasound energy sources have already been explored in literature. In this study, we investigate the use of lasers as a potential energy source for renal denervation. In vitro studies are performed in porcine/ovine renal arteries with focused laser beams at 980 nm, 1210 nm, and 1700 nm to study the ability to damage renal nerves without causing injury to non-target tissue structures like the endothelium. Then, a 980 nm laser catheter prototype is built and used to demonstrate in vivo renal denervation in ovine renal arteries. This study utilizes fiber coupled infrared lasers at 980 nm, 1210 nm, and 1700 nm. In vitro laser denervation studies at 980 nm are performed in both porcine and ovine renal arteries to study the ability of focused laser beams to damage renal nerves without injuring the endothelium. In vitro studies using lasers close to the lipid absorption lines at 1210 nm and 1700 nm are also performed in porcine renal arteries to study the possibility of selectively damaging the renal nerves by targeting the lipid myelin sheaths surrounding the nerves. Then, a laser catheter prototype is designed and built for in vivo renal denervation in ovine renal arteries using the 980 nm laser (powers ranging from 2 to 4 W, 5 seconds per exposure). Histochemical evaluations of the frozen sections are performed using methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay. Histochemical analysis of in vitro laser treatments at 980 nm in porcine and ovine renal arteries show clear evidence of laser-induced renal nerve damage without injury to the endothelium and part of the media. No evidence of selective nerve damage is observed using the 1210 nm and 1700 nm lasers with the current treatment parameters. Histochemical analysis of in vivo laser treatments in ovine renal arteries

  2. AT2 receptors mediate tonic renal medullary vasoconstriction in renovascular hypertension

    OpenAIRE

    Duke, Lisa M; Widdop, Robert E; Kett, Michelle M; Evans, Roger G

    2005-01-01

    Renal medullary blood flow is relatively insensitive to angiotensin II (Ang II)-induced vasoconstriction, due partly to AT1-mediated release of nitric oxide and/or prostaglandins. AT2-receptor activation appears to blunt AT1-mediated vasodilatation within the medullary circulation. This could affect long-term efficacy of antihypertensive pharmacotherapies targeting the renin/angiotensin system, particularly in Ang II-dependent forms of hypertension.We tested the effects of AT1- and AT2-recept...

  3. Altered renal function and the development of angiotensin II-dependent hypertension

    OpenAIRE

    Ashek, Ali

    2011-01-01

    Inappropriate modulation of the renin angiotensin system (RAS) can lead to derangements of blood pressure homeostasis in humans. Cyp1a1-mRen2.F transgenic rats were used to define the renal mechanisms underlying the development of angiotensin II-dependent hypertension. These transgenic rats were previously generated by introducing the mouse Ren2 gene into the rat genome under the control of a Cyp1a1 inducible promoter. The aim of the current investigation was to establish th...

  4. Assessing outcomes to determine whether symptoms related to hypertension justify renal artery stenting.

    Science.gov (United States)

    Modrall, J Gregory; Rosero, Eric B; Timaran, Carlos H; Anthony, Thomas; Chung, Jayer; Valentine, R James; Trimmer, Clayton

    2012-02-01

    The goal of the study was to determine the blood pressure (BP) response to renal artery stenting (RAS) for patients with hypertension urgency, hypertension emergency, and angina with congestive heart failure (angina/congestive heart failure [CHF]). Patients who underwent RAS for hypertension emergencies (n = 13), hypertension urgencies (n = 25), and angina/CHF (n = 14) were included in the analysis. By convention, hypertension urgency was defined by a sustained systolic BP ≥ 180 mm Hg or diastolic BP ≥ 120 mm Hg, while the definition of hypertension emergency required the same BP parameters plus hypertension-related symptoms prompting hospitalization. Patient-specific response to RAS was defined according to modified American Heart Association reporting guidelines. The study cohort of 52 patients had a median age of 66 years (interquartile range 58-72). The BP response to RAS varied significantly according to the indication for RAS. Hypertension emergency provided the highest BP response rate (85%), while the response rate was significantly lower for hypertension urgency (52%) and angina/CHF (7%; P = .03). Only 1 of 14 patients with angina/CHF was a BP responder. Multivariate analysis showed that hypertension urgency or emergency were not independent predictors of BP response to RAS. Instead, the only independent predictor of a favorable BP response was the number of preoperative antihypertensive medications (odds ratio 7.5; 95% confidence interval 2.5-22.9; P = .0004), which is another indicator of the severity of hypertension. Angina/CHF was an independent predictor of failure to respond to RAS (odds ratio 118.6; 95% confidence interval 2.8-999.9; P = .013). Hypertension urgency and emergency are clinical manifestations of severe hypertension, but the number of preoperative antihypertensive medications proved to be a better predictor of a favorable BP response to RAS. In contrast, angina/CHF was a predictor of failure to respond to stenting, providing further

  5. Metrizamide in experimental selective renal angiography

    International Nuclear Information System (INIS)

    Pokorny, L.; Kelemen, J.

    1981-01-01

    Forty-seven dogs or seventy-four kidneys, respectively, were used in studies into the activity of metrizamide (Amipaque). The angiograms were of good quality; as compared with contrast media tested before, the incidence of abnormalities was somewhat lower, and the symptoms (spasm, inhomogeneous nephrogram) were less important. Histological examination showed that plenty of homogeneous pink proteinlike substance had accumulated in many tubules as well as in the lumen of the Bowman's capsules; fibroses were seen in several parts after 7 and 28 days, respectively. However, the evaluation of the renal function showed no considerable changes in the laboratory values. (orig.) [de

  6. Reduced effect of percutaneous renal denervation on blood pressure in patients with isolated systolic hypertension.

    Science.gov (United States)

    Ewen, Sebastian; Ukena, Christian; Linz, Dominik; Kindermann, Ingrid; Cremers, Bodo; Laufs, Ulrich; Wagenpfeil, Stefan; Schmieder, Roland E; Böhm, Michael; Mahfoud, Felix

    2015-01-01

    Renal denervation can reduce blood pressure in certain patients with resistant hypertension. The effect in patients with isolated systolic hypertension (ISH, ≥140/hypertension (CH, ≥140/≥90 mm Hg) defined as baseline office systolic blood pressure (SBP) ≥140 mm Hg despite treatment with ≥3 antihypertensive agents. Renal denervation significantly reduced office SBP and diastolic blood pressure (DBP) at 3, 6, and 12 months by 17/18/17 and 5/4/4 mm Hg in ISH and by 28/27/30 and 13/16/18 mm Hg in CH, respectively. The reduction in SBP and DBP in ISH was lower compared with patients with CH at all observed time points (Pblood pressure was 4/8/7 mm Hg (P=0.032/Pblood pressure after 3, 6, and 12 months, respectively. The ambulatory blood pressure reduction was significantly lower after 3 and 12 months in SBP and after 12 months in ambulatory DBP, respectively. In conclusion, renal denervation reduces office and ambulatory blood pressure in patients with ISH. However, this reduction is less pronounced compared with patients with CH. © 2014 American Heart Association, Inc.

  7. Renal function and risk for cardiovascular events in type 2 diabetic patients with hypertension : the RENAAL and LIFE studies

    NARCIS (Netherlands)

    Eijkelkamp, Wouter B. A.; Zhang, Zhongxin; Brenner, Barry M.; Cooper, Mark E.; Devereux, Richard B.; Dahlof, Bjoern; Ibsen, Hans; Keane, William F.; Lindholm, Lars H.; Olsen, Michael H.; Parving, Hans-Henrik; Remuzzi, Giuseppe; Shahinfar, Shahnaz; Snapinn, Steven M.; Wachtell, Kristian; de Zeeuw, Dick

    Objective To investigate whether a threshold exists for cardiovascular risk in type 2 diabetic patients with hypertension, the association between renal fun Design and methods The RENAAL and LIFE studies enrolled 1513 and 1195 patients with type 2 diabetes and hypertension, respectively. The

  8. Diagnostic criteria of {sup 99m}Tc-diethylenetriaminepentaacetic acid captopril renal scan for the diagnosis of renovascular hypertension by unilateral renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Jin; Hong, Il Ki; Chang, Jae Won; Park, Su Kil; Moon, Dae Hyuk [Asan Medical Center, Seoul (Korea, Republic of)

    2004-12-01

    We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. The study group consisted of 24 patients (m/f = 16/8, age: 39{+-}18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age {<=} 38); 92% and 50% (BCfun{>=} 1 %); 92% and 75% (CBren{>=} 1), and 90% and 60% (CNren{>=} 1), respectively. Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.

  9. An experimental study on vascular changes in renal biopsy injury

    International Nuclear Information System (INIS)

    Lim, Jae Hoon; Han, Man Chung

    1981-01-01

    An experimental study on the vascular alternations of the kidney following biopsy procedure was carried out in 47 kidneys from 28 rabbits to clarify their nature and frequency by renal arteriography and microangiography together with histopathologic investigation. Renal arteriography and microangiography were performed immediately 2 days, 1 week, and 2 weeks after percutaneous biopsy and the findings were correlated with histological nature. The results are summarized as follows: 1. Important biopsy injuries verified by renal arteriography and microangiography were arterial spasm, perfusion defect, arteriovenous fistula, injury to vasa rectae and renal tubules, intrarenal and extrarenal extravasation of contrast media, and arterial obstruction, in order of frequency. 2. Arterial spasm observed in majority of the cases were relieved during the period of 2 weeks. 3. Detectability of perfusion detect was 57% and 72% angiography and microangiography, respectively, and this perfusion defect seemed to be mostly caused by renal infraction due to vascular injury, such as arteriovenous fistula, arterial obstruction and other vascular injuries. 4. Arteriovenous fistula was detected in 28% by angiography and 50% by microangiography. Many of the arteriovenous fistulae appeared to be closed spontaneous within a week. Above findings suggest that renal biopsy procedure results in various degree of vascular injuries with their sequential modification, and that microangiography is assumed the most effective approach in analysis of biopsy injuries such as small arteriovenous fistula, perfusion defect, injury to vasa recta and renal tubules, overcoming the limitation of traditional angiography

  10. Catheter based radiofrequency ablation of renal nerves for the treatment of resistant hypertension

    Directory of Open Access Journals (Sweden)

    Markus P. Schlaich

    2013-03-01

    Full Text Available Introduction Resistant hypertension is a common and growing clinical problem characterized by the failure to attain target blood pressure levels despite adequate use of at least three antihypertensive agents. Objectives The aim of this article is to emphasize the role of novel approaches to treat resistant hypertension. Materials and methods After an excursus on the physiological role of renal nerves on kidney function, volume homeostasis and blood pressure control, this article describes the radiofrequency ablation technology to obtain kidneys denervation. Results Activation of the sympathetic nervous system plays a prominent role as a major regulator of circulatory and metabolic control. The kidneys have a particularly dense afferent sensory and efferent sympathetic innervation and are thereby strategically positioned to be origin as well as target of sympathetic activation. In this context, recent evidence suggests that a novel catheter-based approach to functionally denervate the human kidneys using radiofrequency ablation technology may provide a safe and effective treatment alternative for resistant hypertension and its adverse consequences. Conclusions Despite the availability of numerous safe and effective pharmacological therapies to treat elevated blood pressure, novel therapeutic approaches are warranted to improve the management and prognosis of patients with refractory hypertension. Several clinical trials are currently conducted and planned to further substantiate the blood pressure lowering efficacy of this novel renal denervation procedure.

  11. Acute renal failure and arterial hypertension due to sub capsular hematoma: is percutaneous drainage a feasible treatment?

    DEFF Research Database (Denmark)

    Kobel, Marie Cæcilie; Nielsen, Tommy Kjærgaard; Graumann, Ole

    Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected...... urothelial neoplasm in the right renal pelvis. The left kidney had recently been removed due to renal cell carcinoma. At admission, the patient's blood pressure and plasma creatinine levels were massively elevated. Ultrasonography revealed a moderate right-sided renal subcapsular haematoma. When the patient...

  12. Long-term quality of life and clinical outcomes in patients with resistant hypertension treated with renal denervation

    OpenAIRE

    Agata Krawczyk-Ożóg; Tomasz Tokarek; Katarzyna Moczała; Zbigniew Siudak; Artur Dziewierz; Waldemar Mielecki; Tomasz Górecki; Karolina Gerba; Dariusz Dudek

    2016-01-01

    Introduction: Pharmacological treatment combined with lifestyle modifications is an effective treatment for arterial hypertension. However, there are still patients who do not respond to standard treatments. Patients with pharmacologically resistant hypertension may benefit from renal denervation (RDN). Aim: To assess long-term quality of life (QoL) after RDN and effectiveness in reduction of blood pressure (BP) in patients with resistant hypertension. Material and methods: Fro...

  13. [Role of renal sympathetic nerve and oxidative stress in foot shock-induced hypertension in rats].

    Science.gov (United States)

    Jiang, Ren-Di; Zhang, Zhe; Xu, Jian-Bing; Dong, Tao; Zhang, Guo-Xing

    2015-06-25

    The present study was aimed to investigate the roles of renal sympathetic nerve and oxidative stress in the development of foot shock-induced hypertension. Ninety rats were divided into 6 groups (the number of each group was 15): control group, foot shock group, denervation of renal sympathetic nerve group, denervation of renal sympathetic nerve + foot shock group, Tempol treatment + foot shock group, denervation of renal sympathetic nerve + Tempol treatment + foot shock group. Rats were received electrical foot shock for 14 days (2-4 mA, 75 V, shocks of 50-100 ms every 30 s, for 4 h each session through an electrified grid floor every day). Renal sympathetic ablation was used to remove bilateral renal sympathetic nerve in rats (rats were allowed to recover for one week before the beginning of the foot shock procedure). The antioxidant Tempol was injected intraperitoneally at 1 h before foot shock. Systolic blood pressure was measured at 1 h after foot shock on day 0, 3, 7, 10 and 14. Contents of thiobarbituric acid reactive substance (TBARS), renin, angiotensin II (AngII) and glutathione peroxidase (GSH-Px) in plasma were measured by ELISA after 14-day foot shock. The results showed that systolic blood pressure of foot shock group was significantly increased (P blood pressure induced by foot shock. Levels of TBARS, renin and AngII in plasma were increased significantly in foot shock group compared with that of control group (P oxidative stress and directly or indirectly activate renin-angiotensin-aldosterone system, so the foot shock-induced high blood pressure may be maintained and hypertension may therefore be produced.

  14. Balloon angioplasty, with and without stenting, versus medical therapy for hypertensive patients with renal artery stenosis.

    Science.gov (United States)

    Jenks, Sara; Yeoh, Su Ern; Conway, Bryan R

    2014-01-01

    Atherosclerotic renal artery stenosis is the most common cause of secondary hypertension. Balloon angioplasty with stenting is widely used for the treatment of hypertensive patients with renal artery stenosis but the effectiveness of this procedure in treating hypertension, improving renal function and preventing adverse cardiovascular and renal events remains uncertain. This is an update, to include the results of recent, important large trials, of a review first published in 2003. To compare the effectiveness of balloon angioplasty (with and without stenting) with medical therapy for the treatment of atherosclerotic renal artery stenosis in patients with hypertension. The following outcomes were compared: blood pressure control, renal function, frequency of cardiovascular and renal adverse events, presence or absence of restenosis of the renal artery, side effects of medical therapy, numbers and defined daily doses of antihypertensive drugs. For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched May 2014) and CENTRAL (2014, Issue 4). Bibliographies were also reviewed and trial authors were contacted for more information. Randomised controlled trials (RCTs) comparing balloon angioplasty with medical therapy in hypertensive patients with haemodynamically significant renal artery stenosis (greater than 50% reduction in luminal diameter) and with a minimum follow-up of six months. Data were extracted independently on trial design, participants, interventions and outcome measures. A formal meta-analysis was completed to assess the effect on blood pressure, renal function and cardiovascular and renal adverse events. Peto's odds ratios (ORs) and corresponding 95% confidence intervals (CI) for dichotomous outcomes and mean differences (MD) and corresponding 95% CIs for continuous variables were calculated. Eight RCTs involving 2222 participants with renal artery stenosis were included in

  15. Conventional renal angiography versus renal digital subtraction angiography (DSA) in the study of renovascular hypertension

    International Nuclear Information System (INIS)

    Essinger, A.; Morsier, B. de; Narbel, M.; Raimondi, S.

    1988-01-01

    A cost-benefit analysis comparing conventional renal angiography, IV and IA DSA and spot film cameras has been made in order to quantify the advantages and disadvantages of these techniques in screening for renal artery stenosis. DSA is the best modality of imaging, using very little films, easy to archive, with a spatial resolution inferior to conventional angiography but partially compensated by contrast resolution. The surface dose per image using a 512/512 matrix is two thirds less than a conventional film, giving thus an acceptable dose as long as technical personnel is well trained and thus the number of exposures is kept low. Spot film camera, due to its excellent spatial resolution, its low radiation dose and its low price, can also be used as a screening procedure but requires an arterial injection. DSA has furthermore the advantage of quantifying renal artery stenosis making future percutaneous transluminal angioplasty easier

  16. Effects of xanthine oxidase inhibitors on renal function and blood pressure in hypertensive patients with hyperuricemia.

    Science.gov (United States)

    Kohagura, Kentaro; Tana, Takeshi; Higa, Akira; Yamazato, Masanobu; Ishida, Akio; Nagahama, Kazufumi; Sakima, Atsushi; Iseki, Kunitoshi; Ohya, Yusuke

    2016-08-01

    Hyperuricemia may promote the progression of hypertension and renal dysfunction. However, the effects of hyperuricemia treatment on blood pressure and renal function in adult hypertensive patients with hyperuricemia remain unclear. A total of 137 hypertensive patients with hyperuricemia (96 men and 41 women; mean age of 67 years) who recently started taking xanthine oxidase inhibitors (allopurinol or febuxostat) as outpatients were recruited. Serum uric acid level, estimated glomerular filtration rate (eGFR, ml min(-1) per 1.73 m(2)) and blood pressure (mm Hg) were retrospectively compared immediately before and shortly after starting treatment with xanthine oxidase inhibitors. The mean blood pressure and the eGFR immediately before starting treatment were 128/71 mm Hg and 44.6 ml min(-1) per 1.73 m(2), respectively. Although the eGFR decreased from 46.6 to 44.6 ml min(-1) per 1.73 m(2) before starting treatment with xanthine oxidase inhibitors, it increased to 46.2 ml min(-1) per 1.73 m(2) (P=0.001, compared with immediately before treatment) without any significant changes in blood pressure after the administration of xanthine oxidase inhibitors. Multiple regression analysis revealed that the increase in eGFR after starting xanthine oxidase inhibitor treatment positively correlated with the changes in systolic blood pressure and negatively correlated with the changes in uric acid levels and the use of renin-angiotensin system inhibitors. These results suggest that xanthine oxidase inhibitors may delay the progression of renal dysfunction in adult hypertensive patients with hyperuricemia.

  17. Renal Collectrin Protects against Salt-Sensitive Hypertension and Is Downregulated by Angiotensin II.

    Science.gov (United States)

    Chu, Pei-Lun; Gigliotti, Joseph C; Cechova, Sylvia; Bodonyi-Kovacs, Gabor; Chan, Fang; Ralph, Donna Lee; Howell, Nancy; Kalantari, Kambiz; Klibanov, Alexander L; Carey, Robert M; McDonough, Alicia A; Le, Thu H

    2017-06-01

    Collectrin, encoded by the Tmem27 gene, is a transmembrane glycoprotein with approximately 50% homology with angiotensin converting enzyme 2, but without a catalytic domain. Collectrin is most abundantly expressed in the kidney proximal tubule and collecting duct epithelia, where it has an important role in amino acid transport. Collectrin is also expressed in endothelial cells throughout the vasculature, where it regulates L-arginine uptake. We previously reported that global deletion of collectrin leads to endothelial dysfunction, augmented salt sensitivity, and hypertension. Here, we performed kidney crosstransplants between wild-type (WT) and collectrin knockout ( Tmem27 Y/- ) mice to delineate the specific contribution of renal versus extrarenal collectrin on BP regulation and salt sensitivity. On a high-salt diet, WT mice with Tmem27 Y/- kidneys had the highest systolic BP and were the only group to exhibit glomerular mesangial hypercellularity. Additional studies showed that, on a high-salt diet, Tmem27 Y/- mice had lower renal blood flow, higher abundance of renal sodium-hydrogen antiporter 3, and lower lithium clearance than WT mice. In WT mice, administration of angiotensin II for 2 weeks downregulated collectrin expression in a type 1 angiotensin II receptor-dependent manner. This downregulation coincided with the onset of hypertension, such that WT and Tmem27 Y/- mice had similar levels of hypertension after 2 weeks of angiotensin II administration. Altogether, these data suggest that salt sensitivity is determined by intrarenal collectrin, and increasing the abundance or activity of collectrin may have therapeutic benefits in the treatment of hypertension and salt sensitivity. Copyright © 2017 by the American Society of Nephrology.

  18. Renal mechanisms of salt-sensitive hypertension: contribution of two steroid receptor-associated pathways.

    Science.gov (United States)

    Nishimoto, Mitsuhiro; Fujita, Toshiro

    2015-03-01

    Although salt is a major environmental factor in the development of hypertension, the degree of salt sensitivity varies widely among individuals. The mechanisms responsible for this variation remain to be elucidated. Recent studies have revealed the involvement of two important signaling pathways in renal tubules that play key roles in electrolyte balance and the maintenance of normal blood pressure: the β2-adrenergic stimulant-glucocorticoid receptor (GR)-with-no-lysine kinase (WNK)4-Na(+)-Cl(-) cotransporter pathway, which is active in distal convoluted tubule (DCT)1, and the Ras-related C3 botulinum toxin substrate (Rac)1-mineralocorticoid receptor (MR) pathway, which is active in DCT2, connecting tubules, and collecting ducts. β2-Adrenergic stimulation due to increased renal sympathetic activity in obesity- and salt-induced hypertension suppresses histone deacetylase 8 activity via cAMP/PKA signaling, increasing the accessibility of GRs to the negative GR response element in the WNK4 promoter. This results in the suppression of WNK4 transcription followed by the activation of Na(+)-Cl(-) cotransporters in the DCT and elevated Na(+) retention and blood pressure upon salt loading. Rac1 activates MRs, even in the absence of ligand binding, with this activity increased in the presence of ligand. In salt-sensitive animals, Rac1 activation due to salt loading activates MRs in DCT2, connecting tubules, and collecting ducts. Thus, GRs and MRs are independently involved in two pathways responsible for renal Na(+) handling and salt-sensitive hypertension. These findings suggest novel therapeutic targets and may lead to the development of diagnostic tools to determine salt sensitivity in hypertensive patients. Copyright © 2015 the American Physiological Society.

  19. Upper limit of cerebral blood flow autoregulation in experimental renovascular hypertension in the baboon

    DEFF Research Database (Denmark)

    Strandgaard, S; Jones, J V; MacKenzie, E T

    1975-01-01

    The effect of arterial hypertension on cerebral blood flow was studied by the intracarotid 133Xe clearance method in baboons. The arterial blood pressure was raised in gradual steps with angiotensin. Baboons with renal hypertension of 8-12 weeks duration were studied along with normotensive baboo...

  20. Gemcitabine-induced hemolytic uremic syndrome mimicking scleroderma renal crisis presenting with Raynaud's phenomenon, positive antinuclear antibodies and hypertensive emergency.

    Science.gov (United States)

    Yamada, Yuichiro; Suzuki, Keisuke; Nobata, Hironobu; Kawai, Hirohisa; Wakamatsu, Ryo; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2014-01-01

    A 58-year-old woman who received gemcitabine for advanced gallbladder cancer developed an impaired renal function, thrombocytopenia, Raynaud's phenomenon, digital ischemic changes, a high antinuclear antibody titer and hypertensive emergency that mimicked a scleroderma renal crisis. A kidney biopsy specimen demonstrated onion-skin lesions in the arterioles and small arteries along with ischemic changes in the glomeruli, compatible with a diagnosis of hypertensive emergency (malignant hypertension). The intravenous administration of a calcium channel blocker, the oral administration of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker and the transfusion of fresh frozen plasma were effective for treating the thrombocytopenia and progressive kidney dysfunction. Gemcitabine induces hemolytic uremic syndrome with accelerated hypertension and Raynaud's phenomenon, mimicking scleroderma renal crisis.

  1. Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

    Directory of Open Access Journals (Sweden)

    Machado Ubiratan F

    2011-04-01

    Full Text Available Abstract Background The effects of renal denervation on cardiovascular reflexes and markers of nephropathy in diabetic-hypertensive rats have not yet been explored. Methods Aim: To evaluate the effects of renal denervation on nephropathy development mechanisms (blood pressure, cardiovascular autonomic changes, renal GLUT2 in diabetic-hypertensive rats. Forty-one male spontaneously hypertensive rats (SHR ~250 g were injected with STZ or not; 30 days later, surgical renal denervation (RD or sham procedure was performed; 15 days later, glycemia and albuminuria (ELISA were evaluated. Catheters were implanted into the femoral artery to evaluate arterial pressure (AP and heart rate variability (spectral analysis one day later in conscious animals. Animals were killed, kidneys removed, and cortical renal GLUT2 quantified (Western blotting. Results Higher glycemia (p vs. nondiabetics (p vs. SHR. Conclusions Renal denervation in diabetic-hypertensive rats improved previously reduced heart rate variability. The GLUT2 equally overexpressed by diabetes and renal denervation may represent a maximal derangement effect of each condition.

  2. Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study.

    Science.gov (United States)

    Mehrabadi, Azar; Liu, Shiliang; Bartholomew, Sharon; Hutcheon, Jennifer A; Magee, Laura A; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2014-07-30

    To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada. Retrospective cohort study. Canada (excluding the province of Quebec). All hospital deliveries from 2003 to 2010 (n=2,193,425). Obstetric acute renal failure identified by ICD-10 diagnostic codes. Information on all hospital deliveries in Canada (excluding Quebec) between 2003 and 2010 (n=2,193,425) was obtained from the Canadian Institute for Health Information. Temporal trends in obstetric acute renal failure were assessed among women with and without postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors. Logistic regression was used to determine if changes in risk factors explained the temporal increase in obstetric acute renal failure. Rates of obstetric acute renal failure rose from 1.66 to 2.68 per 10,000 deliveries between 2003-04 and 2009-10 (61% increase, 95% confidence interval 24% to 110%). Adjustment for postpartum haemorrhage, hypertensive disorders, and other factors did not attenuate the increase. The temporal increase in acute renal failure was restricted to deliveries with hypertensive disorders (adjusted increase 95%, 95% confidence interval 38% to 176%), and was especially pronounced among women with gestational hypertension with significant proteinuria (adjusted increase 171%, 71% to 329%). No significant increase occurred among women without hypertensive disorders (adjusted increase 12%, -28 to 72%). The increase in obstetric acute renal failure in Canada between 2003 and 2010 was restricted to women with hypertensive disorders and was especially pronounced among women with pre-eclampsia. Further study is required to determine the cause of the increase among women with pre-eclampsia. © Mehrabadi et al 2014.

  3. Correlation of Serum Parathormone with Hypertension in Chronic Renal Failure Patients Treated with Hemodialysis

    International Nuclear Information System (INIS)

    Baradaran, A.; Nasri, H.

    2005-01-01

    To consider the correlation of serum parathromone on severity of hypertension in end stage renal disease (ESRD) patients on hemodialysis (HD). A cross-sectional study was done on patients with ESRD on treatment with maintenance HD. Levels of serum calcium, phosphorous, alkaline phosphatase, albumin and intact parathormone (iPTH) were measured. Stratification of hypertensive patients was done from stage one to three. The total number of patients studied was 73 (Females=28, Males=45), consisting of 58 non-diabetic (F=22, M=36) and 15 diabetic patients (F=6, M=9). The mean age of the study patients was 46.5+-16 years. The mean duration on HD of the study patients was 21.5+-232.5 months. The mean serum PTH of the study patients was 309+-349 pg/ml and the mean serum alkaline phosphatase was 413+-348 IU/L. There was a significant positive correlation between the stage of hypertension and serum PTH levels (r=0.200, p=0.045). Also, there was a significant positive correlation between stage of hypertension and calcium-phosphorus product (r=0.231, p=0.027). There was no significant correlation between stage of hypertension and serum ALP (r=0.135, p=0.128). Relationship between serum PTH and severity of hypertension in patients on HD needs to be studied in more detail. Hypertension and secondary hyperparathyroidism interact in the process of accelerated atherosclerosis in HD patients thus warranting appropriate measures to control hyperparathyrodism vigorously. (author)

  4. Value of downstream circulation in renal artery stenosis with arterial hypertension: comparison between color Doppler flow and digital renal angiography in 123 patients

    International Nuclear Information System (INIS)

    Grataloup, C.; Challande, P.; Plainfosse, M.C.; Girerd, X.; Belattar, K.; Plouin, P.F.

    1996-01-01

    Digital renal angiography and color Doppler flow were compared for diagnosis of renal artery stenosis in 123 hypertensive patients with a prevalence of renal artery stenosis ≥75% of 21 %. Only color Doppler flow signs found downstream from the stenosis could be quantified. A rising time (RT) >0.07 s was the best marker for renal artery stenosis ≥ 75 % according to a receiver operating characteristic curve with a specificity of 97 %, a sensitivity of 88 %, a positive predictive value of 86 %, a negative predictive value of 98 % and an accuracy of 96 %. Digital renal angiography and color Doppler flow findings for renal artery lesions were classified into 4 degrees with agreement for 86 % of the kidneys. (authors). 13 refs., 5 figs., 8 tabs

  5. Psychobiology of experimental hypertension: evaluation of the Dahl rat lines

    Energy Technology Data Exchange (ETDEWEB)

    Haber, S.B. (Brookhaven National Lab., Upton, NY); Friedman, R.

    1981-01-01

    The Dahl salt-sensitive (DS) and salt-resistant (DR) rat lines were selectively bred to show opposite genetically determined blood pressure responses to excess sodium chloride ingestion. These animals have provided significant anatomical, physiological, and biochemical data concerning the pathological mechanisms of experimental hypertension. Research is also being conducted to determine the relevance of psychobiological and behavioral variables in these two lines. The rationale for the selection and maintenance of the Dahl model and the physiological, biochemical, and behavioral characteristics which distinguish DS and DR rats are presented. Although originally developed for the study of salt-induced hypertension, special attention is given to the application of this animal model in behavior genetic research, stressing its inherent advantages and limitations. The use of the Dahl model in psychobiological studies and the utility of the model for future behavioral, genetic, and psychophysiological research are also detailed.

  6. Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension.

    Science.gov (United States)

    Hering, Dagmara; Marusic, Petra; Walton, Antony S; Lambert, Elisabeth A; Krum, Henry; Narkiewicz, Krzysztof; Lambert, Gavin W; Esler, Murray D; Schlaich, Markus P

    2014-07-01

    Renal denervation (RDN) reduces muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in resistant hypertension. Although a persistent BP-lowering effect has been demonstrated, the long-term effect on MSNA remains elusive. We investigated whether RDN influences MSNA over time. Office BP and MSNA were obtained at baseline, 3, 6, and 12 months after RDN in 35 patients with resistant hypertension. Office BP averaged 166±22/88±19 mm Hg, despite the use of an average of 4.8±2.1 antihypertensive drugs. Baseline MSNA was 51±11 bursts/min ≈2- to 3-fold higher than the level observed in healthy controls. Mean office systolic and diastolic BP significantly decreased by -12.6±18.3/-6.5±9.2, -16.1±25.6/-8.6±12.9, and -21.2±29.1/-11.1±12.9 mm Hg (Phypertension and high baseline MSNA. These observations are compatible with the hypothesis of a substantial contribution of afferent renal nerve signaling to increased BP in resistant hypertension and argue against a relevant reinnervation at 1 year after procedure. © 2014 American Heart Association, Inc.

  7. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Adriana P. Castilho Dugaich

    2010-01-01

    Full Text Available Sympathetic activation in chronic renal failure (CRF is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction of Ang II type 1 receptors (AT1 mRNA in the brainstem compared to controls (C. Tempol but not candesartan into the RVLM decreased MAP in CRF but not in C rats. GABA into the RVLM decreased MAP in CRF (63±8 mmHg more intensely than in C (33±3 mmHg. The results suggest that increased oxidative stress within the RVLM has an important participation to maintain hypertension in CRF rats apparently independently of AT1 Ang II receptors.

  8. Glucagon‐like peptide‐1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP‐1 receptors

    OpenAIRE

    Ronn, Jonas; Jensen, Elisa P.; Wewer Albrechtsen, Nicolai J.; Holst, Jens Juul; Sorensen, Charlotte M.

    2017-01-01

    Abstract Glucagon‐like peptide‐1 (GLP‐1) is an incretin hormone increasing postprandial insulin release. GLP‐1 also induces diuresis and natriuresis in humans and rodents. The GLP‐1 receptor is extensively expressed in the renal vascular tree in normotensive rats where acute GLP‐1 treatment leads to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP‐1 has been reported both to increase and decrease MAP. The aim of this study was to ...

  9. Superoxide dismutase mimetic, tempol, aggravates renal injury in advanced-stage stroke-prone spontaneously hypertensive rats.

    Science.gov (United States)

    Sugama, Ikuko; Kohagura, Kentaro; Yamazato, Masanobu; Nakamura, Takuto; Shinzato, Tomoko; Ohya, Yusuke

    2014-03-01

    The aim of this study was to determine whether antioxidant therapy could relieve hypertension and retard the progression of renal damage in advanced-stage hypertensive rats. Twenty-four-week-old spontaneously hypertensive stroke-prone rats were treated for 8 weeks with the superoxide dismutase mimetic tempol, low-dose or high-dose candesartan (an angiotensin receptor blocker), or hydralazine, and blood pressure and renal damage were compared. Elevated blood pressure and renal damage with heterogeneity were present after 8 weeks, with greater glomerulosclerosis in the juxtamedullary glomeruli than in the superficial glomeruli. Although both tempol and candesartan effectively reduced reactive oxygen species production in the kidney, tempol did not decrease blood pressure and exacerbated urine protein and histological damage, such as glomerulosclerosis and interstitial fibrosis, particularly in juxtamedullary nephrons (tempol vs. untreated: glomerulosclerosis index, 2.0 vs. 1.5, Ptempol-treated rats, suggesting that changes in glomerular hemodynamics may be responsible for the exacerbation of glomerulosclerosis. Both candesartan- and hydralazine-treated rats had glomeruli that were slightly decreased in size. These results suggest that single-antioxidant therapy starting at an advanced-stage may be ineffective for hypertension and rather exacerbate renal damage in nonsalt loaded SHRSP. Furthermore, lowering blood pressure and inhibiting the renin-angiotensin system could be critical for slowing the progression of hypertensive renal damage at an advanced stage.

  10. Maternal Gestational Hypertension-Induced Sensitization of Angiotensin II Hypertension Is Reversed by Renal Denervation or Angiotensin-Converting Enzyme Inhibition in Rat Offspring.

    Science.gov (United States)

    Xue, Baojian; Yin, Haifeng; Guo, Fang; Beltz, Terry G; Thunhorst, Robert L; Johnson, Alan Kim

    2017-04-01

    Numerous findings demonstrate that there is a strong association between maternal health during pregnancy and cardiovascular disease in adult offspring. The purpose of the present study was to test whether maternal gestational hypertension modulates brain renin-angiotensin-aldosterone system (RAAS) and proinflammatory cytokines that sensitizes angiotensin II-elicited hypertensive response in adult offspring. In addition, the role of renal nerves and the RAAS in the sensitization process was investigated. Reverse transcription polymerase chain reaction analyses of structures of the lamina terminalis and paraventricular nucleus indicated upregulation of mRNA expression of several RAAS components and proinflammatory cytokines in 10-week-old male offspring of hypertensive dams. Most of these increases were significantly inhibited by either renal denervation performed at 8 weeks of age or treatment with an angiotensin-converting enzyme inhibitor, captopril, in drinking water starting at weaning. When tested beginning at 10 weeks of age, a pressor dose of angiotensin II resulted in enhanced upregulation of mRNA expression of RAAS components and proinflammatory cytokines in the lamina terminalis and paraventricular nucleus and an augmented pressor response in male offspring of hypertensive dams. The augmented blood pressure change and most of the increases in gene expression in the offspring were abolished by either renal denervation or captopril. The results suggest that maternal hypertension during pregnancy enhances pressor responses to angiotensin II through overactivity of renal nerves and the RAAS in male offspring and that upregulation of the brain RAAS and proinflammatory cytokines in these offspring may contribute to maternal gestational hypertension-induced sensitization of the hypertensive response to angiotensin II. © 2017 American Heart Association, Inc.

  11. Hypertension and hyperglycemia synergize to cause incipient renal tubular alterations resulting in increased NGAL urinary excretion in rats.

    Directory of Open Access Journals (Sweden)

    Ana M Blázquez-Medela

    Full Text Available Hypertension and diabetes are the two leading causes of chronic kidney disease (CKD eventually leading to end stage renal disease (ESRD and the need of renal replacement therapy. Mortality among CKD and ESRD patients is high, mostly due to cardiovascular events. New early markers of risk are necessary to better anticipate the course of the disease, to detect the renal affection of additive risk factors, and to appropriately handle patients in a pre-emptive and personalized manner.Renal function and NGAL urinary excretion was monitored in rats with spontaneous (SHR or L-NAME induced hypertension rendered hyperglycemic (or not as controls.Combination of hypertension and hyperglycemia (but not each of these factors independently causes an increased urinary excretion of neutrophil gelatinase-associated lipocalin (NGAL in the rat, in the absence of signs of renal damage. Increased NGAL excretion is observed in diabetic animals with two independent models of hypertension. Elevated urinary NGAL results from a specific alteration in its tubular handling, rather than from an increase in its renal expression. In fact, when kidneys of hyperglycaemic-hypertensive rats are perfused in situ with Krebs-dextran solution containing exogenous NGAL, they excrete more NGAL in the urine than hypertensive rats. We also show that albuminuria is not capable of detecting the additive effect posed by the coexistence of these two risk factors.Our results suggest that accumulation of hypertension and hyperglycemia induces an incipient and quite specific alteration in the tubular handling of NGAL resulting in its increased urinary excretion.

  12. Blood pressure control in hypertensive pediatric renal transplants: role of repeated ABPM following transplantation.

    Science.gov (United States)

    Krmar, Rafael T; Berg, Ulla B

    2008-10-01

    Hypertension in pediatric renal transplants is a widespread condition associated with high mortality risk in early adult life. Ambulatory blood pressure monitoring (ABPM) was found to be superior to office blood pressure (BP) in identifying true hypertensive and responders to treatment. The aim of this study was to investigate the role of repeated ABPM, performed at yearly intervals following transplantation, in the assessment and decision-making processes of post-transplant hypertension. Thirty-seven recipients (23 males; aged 10.5 +/- 4.3 years) who were followed for 4.3 +/- 2.2 years (range 2-9) after transplantation were eligible for analysis. The mean follow-up time between the baseline (1 year post-transplantation) and the most recent ABPM examination was 3.3 +/- 2.2 years (range 1-8). Throughout the follow-up period, antihypertensive therapy was either started or intensified in 27 recipients. These interventions were decided based on ABPM results obtained on 40 of 44 occasions. At last follow-up, 24 of 29 treated hypertensive recipients displayed controlled BP. This figure was significantly higher compared to our historical hypertensive control recipients in whom ABPM was applied for the first time in treatment at 6 +/- 3.3 years (range 2-15) after transplantation, while therapeutic decisions were driven by office BP measurements (95 % confidence interval (95% CI) for the difference between proportions (80.6-32 %) 36-60 %, P = 0.001). Our study shows that, in a population with high risk for hypertension, repeated ABPM may significantly help to improve BP control.

  13. Inhibition of Extracellular Signal-Regulated Kinases Ameliorates Hypertension-Induced Renal Vascular Remodeling in Rat Models

    Directory of Open Access Journals (Sweden)

    Li Jing

    2011-11-01

    Full Text Available The aim of this study is to investigate the effect of the extracellular signal-regulated kinases 1/2 (ERK1/2 inhibitor, PD98059, on high blood pressure and related vascular changes. Blood pressure was recorded, thicknesses of renal small artery walls were measured and ERK1/2 immunoreactivity and erk2 mRNA in renal vascular smooth muscle cells (VSMCs and endothelial cells were detected by immunohistochemistry and in situ hybridization in normotensive wistar kyoto (WKY rats, spontaneously hypertensive rats (SHR and PD98059-treated SHR. Compared with normo-tensive WKY rats, SHR developed hypertension at 8 weeks of age, thickened renal small artery wall and asymmetric arrangement of VSMCs at 16 and 24 weeks of age. Phospho-ERK1/2 immunoreactivity and erk2 mRNA expression levels were increased in VSMCs and endothelial cells of the renal small arteries in the SHR. Treating SHR with PD98059 reduced the spontaneous hypertension-induced vascular wall thickening. This effect was associated with suppressions of erk2 mRNA expression and ERK1/2 phosphorylation in VSMCs and endothelial cells of the renal small arteries. It is concluded that inhibition of ERK1/2 ameliorates hypertension induced vascular remodeling in renal small arteries.

  14. Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.

    Science.gov (United States)

    Volpe, Massimo; Rosei, Enrico Agabiti; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Mancia, Giuseppe; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Tocci, Giuliano; Virdis, Agostino

    2012-12-01

    Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients

  15. AT(2) receptors mediate tonic renal medullary vasoconstriction in renovascular hypertension.

    Science.gov (United States)

    Duke, Lisa M; Widdop, Robert E; Kett, Michelle M; Evans, Roger G

    2005-02-01

    1. Renal medullary blood flow is relatively insensitive to angiotensin II (Ang II)-induced vasoconstriction, due partly to AT(1)-mediated release of nitric oxide and/or prostaglandins. AT(2)-receptor activation appears to blunt AT(1)-mediated vasodilatation within the medullary circulation. This could affect long-term efficacy of antihypertensive pharmacotherapies targeting the renin/angiotensin system, particularly in Ang II-dependent forms of hypertension. 2. We tested the effects of AT(1)- and AT(2)-receptor blockade on basal cortical and medullary laser Doppler flux (CLDF and MLDF), and on responses to renal arterial infusion of Ang II, in rats with 2 kidney, 1 clip (2K1C) hypertension and sham-operated controls. Studies were carried out in thiobutabarbital (175 mg kg(-1), i.p.) anaesthetised rats, 4 weeks after clipping, or sham surgery (n=6 in each of eight groups). 3. Candesartan (10 microg kg(-1) h(-1), intravenous (i.v.)) reduced mean arterial pressure ( approximately 17%) and increased CLDF ( approximately 24%), similarly in both sham and 2K1C rats, but did not significantly affect MLDF. PD123319 (1 mg kg(-1) h(-1), i.v.) increased basal MLDF (19%) in 2K1C but not sham rats, without significantly affecting other variables. 4. In sham rats, renal arterial infusion of Ang II (1-100 ng kg(-1) min(-1)) dose dependently decreased CLDF (up to 44%), but did not significantly affect MLDF. These effects were markedly blunted in 2K1C rats. After PD123319, Ang II dose dependently increased MLDF (up to 38%) in sham but not 2K1C rats. Candesartan abolished all effects of Ang II, including those seen after PD123319. 5. Our data indicate that AT(1) receptors mediate medullary vasodilatation, which is opposed by AT(2)-receptor activation. In 2K1C hypertension, AT(2)-receptor activation tonically constricts the medullary circulation.

  16. Renal Effects and Underlying Molecular Mechanisms of Long-Term Salt Content Diets in Spontaneously Hypertensive Rats.

    Directory of Open Access Journals (Sweden)

    Rebeca Caldeira Machado Berger

    Full Text Available Several evidences have shown that salt excess is an important determinant of cardiovascular and renal derangement in hypertension. The present study aimed to investigate the renal effects of chronic high or low salt intake in the context of hypertension and to elucidate the molecular mechanisms underlying such effects. To this end, newly weaned male SHR were fed with diets only differing in NaCl content: normal salt (NS: 0.3%, low salt (LS: 0.03%, and high salt diet (HS: 3% until 7 months of age. Analysis of renal function, morphology, and evaluation of the expression of the main molecular components involved in the renal handling of albumin, including podocyte slit-diaphragm proteins and proximal tubule endocytic receptors were performed. The relationship between diets and the balance of the renal angiotensin-converting enzyme (ACE and ACE2 enzymes was also examined. HS produced glomerular hypertrophy and decreased ACE2 and nephrin expressions, loss of morphological integrity of the podocyte processes, and increased proteinuria, characterized by loss of albumin and high molecular weight proteins. Conversely, severe hypertension was attenuated and renal dysfunction was prevented by LS since proteinuria was much lower than in the NS SHRs. This was associated with a decrease in kidney ACE/ACE2 protein and activity ratio and increased cubilin renal expression. Taken together, these results suggest that LS attenuates hypertension progression in SHRs and preserves renal function. The mechanisms partially explaining these findings include modulation of the intrarenal ACE/ACE2 balance and the increased cubilin expression. Importantly, HS worsens hypertensive kidney injury and decreases the expression nephrin, a key component of the slit diaphragm.

  17. Elastin insufficiency causes hypertension, structural defects and abnormal remodeling of renal vascular signaling.

    Science.gov (United States)

    Owens, Elizabeth A; Jie, Li; Reyes, Beverly A S; Van Bockstaele, Elisabeth J; Osei-Owusu, Patrick

    2017-11-01

    Elastin deficiency causes vascular stiffening, a leading risk for hypertension and chronic kidney disease (CKD). The mechanisms mediating hypertension and/or CKD pathogenesis due to elastin deficiency are poorly understood. Using the elastin heterozygous (Eln+/-) mouse model, we tested whether renal dysfunction due to elastin deficiency occurs independently of and precedes the development of hypertension. We assessed blood pressure and renal hemodynamics in 30-day and 12-week-old male and female mice. At P30, blood pressure of Eln+/- mice was similar to wild-type controls; however, renal blood flow was lower, whereas renal vascular resistance was augmented at baseline in Eln+/- mice. At 12 weeks, renal vascular resistance remained elevated while filtration fraction was higher in male Eln+/- relative to wild-type mice. Heterozygous mice showed isolated systolic hypertension that was evident only at nighttime. Acute salt loading with 6% dietary sodium increased daytime systolic blood pressure only in male Eln+/- mice, causing a rightward shift and blunted slope of the pressure-natriuresis curve. Renal interlobar artery basal tone and myogenic response to increasing intraluminal pressure at day 10 were similar, whereas they were augmented at day 30 and at 12 weeks old in Eln+/- mice, and normalized by the AT1R blocker, candesartan. Heterozygous mice also exhibited podocyte foot process damage that persisted even when blood pressure was normalized to wild-type levels with hydralazine. Thus, elastin insufficiency triggers structural defects and abnormal remodeling of renal vascular signaling involving AT1R-mediated vascular mechanotransduction and renal hyperfiltration with increased blood pressure sensitivity to dietary sodium contributing to systolic hypertension. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  18. Furosemide-caused alterations in the renogram of patients with renal disease and hypertension

    International Nuclear Information System (INIS)

    Camargo, E.E.; Papaleo Netto, M.; Dias Neto, A.L.; Carvalho, N.

    1975-01-01

    In 21 patients suffering - separately or simultaneously - from hypertension or nephropathy, the behavior of the differential effective renal plasma flow (ERPF sub(R) and ERPF sub(D)) and of the following time parameters of the renogram: time from point of injection to point of maximum count rate (T sub(max)), time from maximum count rate to point of 1/2 maximum count (T sub(1/2)), 'secretory' (T sub(S)) 'excretory' (T sub(ex)) half-lives of hippuran- 131 I are studied, before and after administration of furosemide. The diuretic markedly shortens all the time parameters studied, but does not change the differential effective renal plasma flow. Results suggest an action of the drug on the proximal tubule and also on loop of Henle. Neither the rate of the supply of the tracer to the tubular cell nor the tracer's pathway are altered by the diuretic [pt

  19. Radioisotopic studies in renovascular hypertension before and after surgery or percutaneous transluminal renal angioplasty

    International Nuclear Information System (INIS)

    Mantero, F.; Fallo, F.; Scaroni, C.; Ridolfi, P.; Sicolo, M.; Varotta, L.; Bui, F.

    1987-01-01

    Over the past few years, radioisotopic studies have emerged as reliable diagnostic procedures in the screening for renovascular hypertension. More specifically, dynamic reno-scintigraphy (DRS) has been proved to be very sensitive in revealing hypoperfusion due to renal artery stenosis, although it cannot compete with the accuracy of arteriography, which only may provide a definitive diagnosis. Moreover, DRS appears to be a convenient test in clinical routine investigation because of its simplicity, low dose of tracer and high margin of safety for the patients

  20. Postural Effect on Renal Function In Cases of Pregnancy-Induced Hypertension

    OpenAIRE

    丸山, 晋司; Maruyama, Shinji

    1989-01-01

    Postual effect on renal function was analysed on the cases of pregnancy-induced hypertension (PIH) (n=11) compared with cases of normotensive pregnancies (n=12) and non-pregnant women (n=9). In non-pregnant women, GFR, RBF and RPF showed no changes in relation to the changing posture (supine and left lateral). In normal pregnant women and cases of PIH, GFR, RBF and RPF significantly increased on changing their posture from supine to left lateral at third trimester. Especially, patients with P...

  1. Anesthetic management of patients undergoing extra-anatomic renal bypass surgery for renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Kumar Bhupesh

    2011-01-01

    Full Text Available Renal artery disease is the most common cause for surgically curable form of hypertension. In a small subset of patients with severe aortic disease where the aorta is not suitable for endovascular technique and to provide an arterial inflow, an extra-anatomic renal bypass surgery (EARBS is an option. Anesthetic management of such procedures has not been described so far in the literature. We retrospectively analyzed the anesthetic techniques used in all patients who underwent EARBS between February 1998 and June 2008 at this institute. We also further analyzed data concerning blood pressure (BP control and renal function response following surgery as outcome variable measures. A total of 11 patients underwent EARBS during this period. Five received oral clonidine with premedication. During laryngoscopy, esmolol was used in 4 patients, while lignocaine was used in remaining 7 patients. Of 11 patients, 7 showed significant hemodynamic response to laryngoscopy and intubation; among these, one had oral clonidine with premedicant, and 6 received lignocaine just before laryngoscopy. Intravenous vasodilators were used to maintain target BP within 20% of baseline during perioperative period. All patients received renal protective measures. During follow-up, 10% were considered cured, 70% had improved BP response, while 20% failed to show improvement in BP response. Renal functions improved in 54.5%, remain unchanged in 36.5%, and worsened in 9% of patients. Use of clonidine during premedication and esmolol before laryngoscopy were beneficial in attenuating hemodynamic response to laryngoscopy, while use of vasodilators to maintain target BP within 20% of baseline, and routine use of renal protective measures appear to be promising in patients undergoing EARBS.

  2. Relationship between diurnal blood pressure and renal histopathological changes in white coat hypertension.

    Science.gov (United States)

    Tatar, Erhan; Uslu, Adam; Tasli, Funda; Karatas, Murat

    2017-08-01

    Multiple epidemiological studies have clearly demonstrated the macrovascular risks associated with white coat hypertension (WCH) or sustained hypertension (SH). In patients with WCH, there is no literature available on renal histopathological changes and that on blood pressure pattern and native kidney outcome is scant. We aimed to clarify the relationship between blood pressure variables and pathological features of kidney biopsies in living kidney donors with WCH. This cross-sectional study included living kidney donors with WCH (n = 10) and SH (n = 10), and 20 healthy kidney donors with similar demographic features (control group). Kidney allograft biopsy samples were obtained during transplantation and chronic glomerular, vascular and tubulointertitial changes were semiquantitatively scored according to the Banff classification. The mean age of the 20 hypertensive subjects (Group 1) and controls (Group 2) was 59.3 ± 8.5 versus 59.6 ± 7.6 years and almost half were female. There was no difference in renal function parameters between the groups; however, kidney histopathology in Group 1 was worse than Group 2 with a chronicity index of 2.80 ± 1.67 versus 1.75 ± 1.16 (p = 0.02). There was no difference between histopathological scores of patients with WCH or SH (chronicity index: 2.60 ± 1.43 vs. 2.70 ± 1.70, p = 0.88). Night-to-day mean arterial pressure (MAP) ratio was significantly associated with chronicity index in patients with WCH. Moreover, WCH patients with non-dipper hypertensive pattern had a worse chronicity index. Significant histopathological alterations in the kidney were observed in patients with WCH and SH, and were accentuated in WCH patients with non-dipper blood pressure pattern.

  3. Depressive Effects of Chronic Intermittent Hypobaric Hypoxia on Renal Vascular Hypertension through Enhancing Baroreflex.

    Science.gov (United States)

    Li, Na; Guan, Yue; Zhang, Li; Tian, Yanming; Zhang, Yi; Wang, Sheng

    2016-08-31

    Baroreflex function plays a critical role in the maintenance of cardiovascular homeostasis and is impaired in different types of hypertension in both human and animals. Chronic intermittent hypobaric hypoxia (CIHH) facilitates baroreflex in anesthetized rats. The aim of present study was to investigate the effect of CIHH on arterial blood pressure (ABP) and baroreflex function in renal vascular hypertension (RVH) rats. Adult male Sprague-Dawley rats were randomly divided into four groups: Sham-operated (SHAM), RVH, CIHH treatment (CIHH), and RVH plus CIHH (RVH+CIHH) groups. RVH was induced by 2-kidney-1-clip method. CIHH rats experienced 28-day (6 h per day) hypobaric hypoxia simulating 5,000 m altitude in hypobaric chamber. Renal sympathetic nerve activity (RSNA), ABP and heart rate (HR) were recorded. Baroreflex was elicited by intravenous infusion of phenylephrine (PE, 25 μg/kg) and sodium nitroprusside (SNP, 10 μg/KG), respectively. Baroreflex curves were plotted by using RSNA or HR v.s. mean arterial pressure (MAP). The systolic ABP measured by tail-cuff method was significantly higher in RVH rats compared with SHAM rats. Furthermore, RSNA-MAP baroreflex curves were shifted to the right and upward with a decrease in baroreflex gain (Gmax) in RVH rats. CIHH treatment significantly decreased systolic ABP in RVH rats to the level in SHAM rats and shifted RSNA-MAP baroreflex curves to the left and downward with a normalized Gmax. These data suggest that CIHH treatment produces an anti-hypertensive effect in RVH rats, likely due to facilitating baroreflex function. Thus, CIHH represents a novel potential therapeutics to treat hypertension.

  4. Anakinra reduces blood pressure and renal fibrosis in one kidney/DOCA/salt-induced hypertension.

    Science.gov (United States)

    Ling, Yeong Hann; Krishnan, Shalini M; Chan, Christopher T; Diep, Henry; Ferens, Dorota; Chin-Dusting, Jaye; Kemp-Harper, Barbara K; Samuel, Chrishan S; Hewitson, Timothy D; Latz, Eicke; Mansell, Ashley; Sobey, Christopher G; Drummond, Grant R

    2017-02-01

    To determine whether a clinically-utilised IL-1 receptor antagonist, anakinra, reduces renal inflammation, structural damage and blood pressure (BP) in mice with established hypertension. Hypertension was induced in male mice by uninephrectomy, deoxycorticosterone acetate (2.4mg/d,s.c.) and replacement of drinking water with saline (1K/DOCA/salt). Control mice received uninephrectomy, a placebo pellet and normal drinking water. 10days post-surgery, mice commenced treatment with anakinra (75mg/kg/d, i.p.) or vehicle (0.9% saline, i.p.) for 11days. Systolic BP was measured by tail cuff while qPCR, immunohistochemistry and flow cytometry were used to measure inflammatory markers, collagen and immune cell infiltration in the kidneys. By 10days post-surgery, 1K/DOCA/salt-treated mice displayed elevated systolic BP (148.3±2.4mmHg) compared to control mice (121.7±2.7mmHg; n=18, Prenal expression of some (CCL5, CCL2; n=7-8; P0.05). Anakinra reduced renal collagen content (n=6, Prenal and glomerular hypertrophy (n=8-9, Prenal anti-fibrotic actions, anakinra had minimal effects on inflammation and leukocyte infiltration in mice with 1K/DOCA/salt-induced hypertension. Future studies will assess whether the anti-hypertensive actions of anakinra are mediated by protective actions in other BP-regulating or salt-handling organs such as the arteries, skin and brain. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Hypertension, Chronic Kidney Disease, and Renal Pathology in a Child with Hermansky-Pudlak Syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Gordillo

    2011-01-01

    Full Text Available We report a child with Hermansky-Pudlak Syndrome (HPS and chronic kidney disease (stage II with histological diagnosis of focal segmental glomerulosclerosis (FSGS. A 15-year-old male of Puerto Rico ancestry with history of HPS, hypertension (HTN, asthma, obesity, and chronic kidney disease (CKD stage II presented with new-onset proteinuria without edema. His blood pressure had been controlled, serum creatinine had been 0.9–1.4 mg/dL, and first morning urine protein/creatinine ratio (UPC ranged from 0.2 to 0.38. Due to persistent nonorthostatic proteinuria with CKD, renal biopsy was performed and FSGS (not otherwise specified with chronic diffuse tubulopathy (tubular cytoplasmic droplets and acute tubular injury was reported. Ceroid-like material is known to infiltrate tissues (i.e., lungs, colon, and kidney in HPS, but the reason for the renal insufficiency is unknown. Nonspecific kidney disease and in one adult case IgA nephropathy with ANCA-positive glomerulonephritis have previously been reported in patients with Hermansky-Pudlak syndrome. To our knowledge, we report the first pediatric renal pathology case of HPS associated with CKD. This paper discusses presentation and management of renal disease in HPS.

  6. Spectrum of renal injury in pregnancy-induced hypertension: Experience from a single center in India

    Directory of Open Access Journals (Sweden)

    Mahesh Eswarappa

    2017-01-01

    Full Text Available Pregnancy-induced hypertension (PIH is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI. In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M. S. Ramaiah Medical College, were included in the study. The study duration was from 2010 to 2014. Details regarding epidemiologic data, obstetric data, laboratory parameters as well as maternal, renal, and fetal outcomes were noted. Patients with preexisting hypertension, diabetes mellitus, or chronic kidney disease were excluded from analysis. The overall incidence of preeclampsia was 3.4%. Hemolysis, elevated liver enzymes, and low platelets syndrome was seen in 31 patients (9%; 56 patients (19% had AKI with a mean serum creatinine of 3.2 mg/dL and mean proteinuria of 2.8 g/24 h. Nineteen patients required dialysis. Persistent renal failure was seen in 2.5% of the cohort. Maternal mortality was 2.5%, largely secondary to sepsis. Primiparity was a major risk factor. In this study, we found a low rate of preeclampsia in a low-to-moderate risk cohort, with an incidence of AKI and maternal mortality consistent with reported literature.

  7. Renal handling of calcium and phosphorus in experimental renal hyperparathyroidism in dogs.

    Science.gov (United States)

    García-Rodríguez, M Belén; Pérez-García, Carlos C; Ríos-Granja, M Angeles; Cano-Rábano, María J; Peña-Penabad, Marina; Gallego-Morales, David; García-Partida, Paulino; Diez-Prieto, Inmaculada

    2003-01-01

    Twenty-four hour urinary excretion, fractional excretion and the filtered load of calcium and phosphorus were monitored as hyperparathyroidism evolved in a model of progressive canine renal failure. Thirteen beagles of both sexes aged four and a half months were used. Nine of them were subjected to a renal damaging schedule (neomycine, 60 mg/kg/48 h, IM, 32 weeks) in order to induce chronic renal failure leading to secondary hyperparathyroidism (2HPT group). The remaining four were kept as the control group. The experiment was conducted over 32 weeks. Blood and 24 h urine were collected every four weeks. Calcium, phosphorus and creatinine were analyzed. Plasma parathormone and calcitonin were determined at weeks 0, 12, 24 and 32. The level of renal function in the 2HPT animals was reduced to 25% of that of the controls (endogenous creatinine clearance was 0.45 +/- 0.22 mL/min/kg as opposed to 1.81 +/- 0.54 mL/min/kg). Hyperparathyroidism was confirmed by a progressive increase in the levels of the parathyroid hormone. Calcitonin levels were not modified. A tendency to hypocalcaemia was observed, reaching statistically significant levels from the twenty-eighth week of the study, when hyperphosphataemia also became significant. Daily urinary excretion of calcium and phosphorus remained at values considered normal throughout the experiment with no alteration imputable to the impaired renal function. This is explained by the decrease in the filtered load of these elements (in both cases statistically significant from the 24th week on) being associated with an increase in their fractional excretion. Thus, calcium and phosphorus urinary excretion values could be maintained in a normal range up to the end of the experiment, showing that renal calcium handling in dogs with experimentally induced renal failure seems to differ from that observed in human patients.

  8. COX2 inhibition during nephrogenic period induces ANG II hypertension and sex-dependent changes in renal function during aging.

    Science.gov (United States)

    Reverte, Virginia; Tapia, Antonio; Loria, Analia; Salazar, Francisco; Llinas, M Teresa; Salazar, F Javier

    2014-03-01

    This study was performed to test the hypothesis that ANG II contributes to the hypertension and renal functional alterations induced by a decrease of COX2 activity during the nephrogenic period. It was also examined whether renal functional reserve and renal response to volume overload and high sodium intake are reduced in 3-4- and 9-11-mo-old male and female rats treated with vehicle or a COX2 inhibitor during nephrogenic period (COX2np). Our data show that this COX2 inhibition induces an ANG II-dependent hypertension that is similar in male and female rats. Renal functional reserve is reduced in COX2np-treated rats since their renal response to an increase in plasma amino acids levels is abolished, and their renal ability to eliminate a sodium load is impaired (P renal excretory ability is similar in both sexes during aging but does not induce the development of a sodium-sensitive hypertension. However, the prolonged high-sodium intake at 9-11 mo of age leads to a greater proteinuria in male than in female (114 ± 12 μg/min vs. 72 ± 8 μg/min; P Renal hemodynamic sensitivity to acute increments in ANG II is unaltered in both sexes and at both ages in COX2np-treated rats. In summary, these results indicate that the reduction of COX2 activity during nephrogenic period programs for the development of an ANG II-dependent hypertension, reduces renal functional reserve to a similar extent in both sexes, and increases proteinuria in males but not in females when there is a prolonged increment in sodium intake.

  9. Does consumption of an aqueous extract of Hibscus sabdariffa affect renal function in subjects with mild to moderate hypertension?

    Science.gov (United States)

    Nwachukwu, Daniel Chukwu; Aneke, Eddy Ikemefuna; Nwachukwu, Nkiru Zuada; Azubike, Nkiru; Obika, Lenard Fidelis

    2017-01-01

    Hibiscus sabdariffa (HS) has been traditionally used as a herbal medicine in Nigeria mainly because of its antihypertensive action. In view of the recent increase in the prevalence of renal failure, we have investigated the effect of HS consumption on renal function in Nigerians with mild to moderate hypertension. A total of 78 newly diagnosed but untreated subjects with mild to moderate hypertension attending the medical outpatients unit of Enugu State University Teaching Hospital (Enugu, Nigeria) were recruited for the study. These subjects were randomly divided into three equally sized groups that received HS or lisinopril (treatment groups) or placebo (control group), once daily for 4 weeks. Indices of renal function (urine volume and creatinine clearance) were measured at baseline and weekly throughout the study period. HS and lisinopril significantly increased (P hypertension.

  10. Hypertension

    Science.gov (United States)

    ... Hypertension Triglycerides Featured Resource Find an Endocrinologist Search Hypertension September 2017 Download PDFs English Espanol Editors Fady ... Additional Resources MedlinePlus (NIH) Mayo Clinic What is hypertension? Hypertension, or high blood pressure, is a leading ...

  11. Preserved regulation of renal perfusion pressure by small and intermediate conductance K-Ca channels in hypertensive mice with or without renal failure

    DEFF Research Database (Denmark)

    Waeckel, L.; Bertin, F.; Clavreul, N.

    2015-01-01

    The purpose of this study was to assess, in the murine kidney, the mechanisms underlying the endothelium-dependent control of vascular tone and whether or not, in a severe model of hypertension and renal failure, K-Ca channels contribute to its regulation. Wild-type (BL) and double-transgenic fem......The purpose of this study was to assess, in the murine kidney, the mechanisms underlying the endothelium-dependent control of vascular tone and whether or not, in a severe model of hypertension and renal failure, K-Ca channels contribute to its regulation. Wild-type (BL) and double......-transgenic female mice expressing human angiotensinogen and renin (AR) genes received either control or a high-salt diet associated to a nitric oxide (NO) synthase inhibitor treatment (BLSL and ARSL). Changes in renal perfusion pressure (RPP) were measured in isolated perfused kidneys. BLSL and AR were moderately...... hypertensive without kidney disease while ARSL developed severe hypertension and renal failure. In the four groups, methacholine induced biphasic endothelium-dependent responses, a transient decrease in RPP followed by a cyclooxygenase-dependent increase in RPP. In the presence or not of indomethacin...

  12. Dietary approach to stop hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

    NARCIS (Netherlands)

    Osté, M.C.J.; Gomes-neto, A.W.; Corpeleijn, E.; Gans, R.O.B.; De Borst, M.H.; Van Den Berg, E.; Soedamah-Muthu, S.S.; Kromhout, D.; Navis, G.J.; Bakker, S.J.L.

    Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective

  13. Hypertension in children. Increased efficacy of technetium Tc/sup 99m/ succimer in screening for renal disease

    International Nuclear Information System (INIS)

    Rosen, P.R.; Treves, S.; Ingelfinger, J.

    1985-01-01

    Renal scintigraphy with technetium Tc-99m succimer (DMSA) and technetium Tc-99m pentetate (DTPA) was used to study 80 hypertensive pediatric and adolescent patients. Renal abnormalities such as asymmetry of function, size, or shape were identified in 13 patients. Both excretory urography and technetium Tc-99m pentetate studies were successful in detecting 54% of the abnormalities in patients studied; technetium Tc-99m succimer identified 92%. The accuracy of the latter was 96%, with a specificity of 97%. The ability of technetium Tc-99m succimer renal scintigraphy to identify accurately the presence or absence of renal abnormalities warrants its inclusion in the initial examination of pediatric and adolescent patients with hypertension

  14. Mizoribine ameliorates renal injury and hypertension along with the attenuation of renal caspase-1 expression in aldosterone-salt-treated rats.

    Science.gov (United States)

    Doi, Toshiki; Doi, Shigehiro; Nakashima, Ayumu; Ueno, Toshinori; Yokoyama, Yukio; Kohno, Nobuoki; Masaki, Takao

    2014-01-01

    Aldosterone-salt treatment induces not only hypertension but also extensive inflammation that contributes to fibrosis in the rat kidney. However, the mechanism underlying aldosterone-salt-induced renal inflammation remains unclear. Pyroptosis has recently been identified as a new type of cell death that is accompanied by the activation of inflammatory cytokines. We hypothesized that aldosterone-salt treatment could induce inflammation through pyroptosis and that mizoribine, an effective immunosuppressant, would ameliorate the renal inflammation that would otherwise cause renal fibrosis. Ten days after recovery from left uninephrectomy, rats were given drinking water with 1% sodium chloride. The animals were divided into three groups (n = 7 per group): (1) vehicle infusion group, (2) aldosterone infusion group, or (3) aldosterone infusion plus oral mizoribine group. Aldosterone-salt treatment increased the expression of the nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain containing 3 and caspase-1, and also increased the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells. However, the oral administration of mizoribine attenuated these alterations. Furthermore, mizoribine inhibited hypertension and renal fibrosis, and also attenuated the aldosterone-induced expression of serum/glucocorticoid-regulated kinase and α epithelial sodium channel. These results suggest that caspase-1 activation plays an important role in the development of inflammation induced by aldosterone-salt treatment and that it functions as an anti-inflammatory strategy that protects against renal injury and hypertension.

  15. Post-Patent Ductus Arteriosus ligation syndrome with hypertension and masking of renal artery stenosis in an infant.

    Science.gov (United States)

    ElSeed Peterson, Erica E; Mauriello, Daniel

    2018-02-07

    Post-patent ductus arteriosus ligation syndrome is common, but rarely has hypertension been described following ductal ligation with an unclear mechanism. We report a case of an infant who exhibited features of post-patent ductus arteriosus ligation syndrome and hypertension, but was found to have bilateral renal artery stenosis. Increased systemic vascular resistance can be masked by the parallel circuit physiology of a patent ductus arteriosus.

  16. Comparative assessment of captopril and aspirin administration during dynamic renal scintigraphy in diagnosing renovascular hypertension

    International Nuclear Information System (INIS)

    Kostadinova, I.; Simeonova, A.

    1997-01-01

    The shortcoming of the captopril test used as a noninvasing screening method in diagnosing renovascular hypertension (RVH) is that in the course of study, ACE-inhibitors (angiotensin-converting enzymes) and diuretics should be discontinued from the therapeutic scheme of patients. The authors compare it to the alternative one with aspirin. The study covers eight patients with angiographic evidence of RVH with significant unilateral stenosis of the renal artery. The obtained results are evaluated on the ground of quantitative (T max , T 1/2 , divided renal function and retention index), as well as qualitative criteria (visual assay). As shown by the results the functional effect of captopril is rather markedly expressed in 6 patients, and the effect of aspirin - in 2. It is concluded that captopril test is more accurate in demonstrating RVH, but in patients with firm clinical evidence of a significant angiotensin II-dependent RVH and negative captopril test, it is advisable to apply aspirin test with a view to differentiate renovascular from essential hypertension

  17. Renal Denervation for Treatment of Hypertension: a Second Start and New Challenges.

    Science.gov (United States)

    Persu, Alexandre; Kjeldsen, Sverre; Staessen, Jan A; Azizi, Michel

    2016-01-01

    Following the publication of the randomized controlled but open-label trial Symplicity HTN-2, catheter-based renal sympathetic denervation was proposed as a novel treatment for drug-resistant hypertension. Thousands of procedures were routinely performed in Europe, Australia and Asia, and many observational studies were published. A sudden shift from overoptimistic views to radical scepticism occurred later, when the large US randomized sham-controlled trial Symplicity HTN-3 failed to meet its primary blood pressure lowering efficacy endpoint. Experts are divided on the reasons accounting for the large discrepancy between the results of initial studies and those of Symplicity HTN-3. Indeed, the blood pressure lowering effect associated with renal denervation was overestimated in initial trials due to various patient and physician-related biases, whereas it could have been underestimated in Symplicity HTN-3, which was well designed but not rigorously executed. Still, there is a large consensus on the need to further study catheter-based renal denervation in more controlled conditions, with particular emphasis on identification of predictors of blood pressure response. US and European experts have recently issued very similar recommendations on design of upcoming trials, procedural aspects, drug treatment, patient population and inclusion-exclusion criteria. Application of these new standards may represent a second chance for renal denervation to demonstrate--or not--its efficacy and safety in various patient populations. With its highly standardized treatment regimen, the French trial DENERHTN paved the way for this new approach and may inspire upcoming studies testing novel renal denervation systems in different populations.

  18. Acute renal failure and arterial hypertension due to sub capsular hematoma: is percutaneous drainage a feasible treatment?

    DEFF Research Database (Denmark)

    Kobel, Marie Cæcilie; Nielsen, Tommy Kjærgaard; Graumann, Ole

    Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected......, but recent case reports have described successful management by laparoscopy-assisted and radiology-assisted drainage, as described in this case report....

  19. Glucagon-like peptide-1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP-1 receptors

    DEFF Research Database (Denmark)

    Ronn, Jonas; Jensen, Elisa P; Wewer Albrechtsen, Nicolai J

    2017-01-01

    in the kidney from SHR. However, acute intrarenal infusion of GLP-1 increased MAP, RBF, dieresis, and natriuresis without affecting heart rate in both rat strains. These results suggest that the acute renal effects of GLP-1 in SHR are caused either by extrarenal GLP-1 receptors activating other mechanisms (e...... to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP-1 has been reported both to increase and decrease MAP. The aim of this study was to examine expression of renal GLP-1 receptors in spontaneously hypertensive rats (SHR) and to assess the effect...... of acute intrarenal infusion of GLP-1. We hypothesized that GLP-1 would increase diuresis and natriuresis and reduce MAP in SHR. Immunohistochemical staining and in situ hybridization for the GLP-1 receptor were used to localize GLP-1 receptors in the kidney. Sevoflurane-anesthetized normotensive Sprague...

  20. Renal dysfunction and state of metabolic and hemodynamic factors in patients with arterial hypertension

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    Klochkov V.A.

    2011-12-01

    Full Text Available The aim of the investigation is to carry out comparative evaluation of metabolic and hemodynamic indices in patients with arterial hypertension (AH and renal dysfunction; to study the interrelation between arterial blood pressure level normalization and the presence or lack of microalbuminuria (MAU in the morning urine portion of patients with AH after therapy with antihypertensive preparations (APs of various groups. Methods. 121 persons have been investigated, 91 out — patients of both sexes, aged 33-55, with the diagnosis of arterial hypertension of stage II risk III, who have been taking Perindopril, Telmisartan and Bisoprolol for3 months. The control of arterial pressure level, biochemical analysis of metabolic indices and morning urine portion test for microalbuminuria has been carried out. Results. MAU has been revealed in 17,6% patients, occurring more frequently in men than in women. Microalbuminuria is accompanied by reliable decrease of total and ionized calcium and magnesium concentrations, an increase of potassium level in blood plasma, increase of cholesterol, triglycerides, glucose and levels. Patients with AH and renal dysfunction reliably demonstrate higher levels of systolic and diastolic arterial pressure in the morning and evening hours, their normalization effect after APs intake is significantly interconnected with MAU presence. Conclusion. In patients with AH and MAU the main risk factors of cardio-vascular diseases development are more expressed. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. While carrying out antihypertensive therapy the presence of MAU should be taken into consideration

  1. Renin Response to Intravenous Furosemide in Hypertension of Chronic Renal Failure

    International Nuclear Information System (INIS)

    Choe, Kang Won

    1978-01-01

    It has been suggested that plasma renin activity (PRA) and its response to volume depletion may be abnormal in that it shows little or exaggerated change in patients with chronic renal failure and hypertension. Intravenous furosemide stimulation test was performed in 46 control subjects and 51 patients with chronic renal failure and/or malignant hypertension in order to evaluate PRA response. In contrast to the consistent increase in PRA in control subjects (from 2.5±1.95 to 4.5±2.51 ng/m1/hr), no consistent increase was observed in patients with chronic renal failure, especially in those who showed favorable response to antihypertensive therapy (from 2.5±2.21 to 2.9±2.46 ng/ml/hr). But poor responder to antihypertensive treatment showed considerably higher PRA before and after furosemide stimulation (from 4.9±1.96 to 6.4±1.71 ng/ml/hr) than the responder group did. Moreover, this group seemed to retain the ability to increase PRA in response to intravenous furosemide stimulation. Thus it became apparent that responder group was unable to increase PRA normally in response to furosemide as well as volume depletion, while poor responder seemed to retain that ability. Thus intravenous furosemode may serve as a convenient way to differentiate those who might be benefited by conservative antihypertensive measures from those who would require more drastic measures such as bilateral nephrectomy for their optimal blood pressure control.

  2. Protection of estrogen in portal hypertension gastropathy: an experimental model

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    Maria Isabel Morgan-Martins

    2011-09-01

    Full Text Available CONTEXT: Portal hypertension is a complication secondary to cirrhosis that is characterized by increased blood flow and/or vascular resistance in the portal system, causing the appearance of a hyperdynamic collateral circulation. Partial portal vein ligation is an experimental model used in rats to study the pathophysiological mechanisms involved in pre-hepatic portal hypertension. Estrogen E2 is an antioxidant molecule with various physiological actions. OBJECTIVES: To evaluate the antioxidant activity of endogenous estrogen in an experimental model of partial portal vein ligation by comparing intact with castrated rats. METHODS: Twenty Wistar rats, weighing on average 250 g were used and divided into four groups: sham-operated (SO; intact (I with partial portal vein ligation (I + PPVL, castrated (C and castrated with partial ligation of the vein (C + PPVL. Day 1: castration or sham-operation; day 7, PPVL surgery; on day 15 post-PPVL, portal pressure in the mesenteric vein of rats was measured on polygraph Letica. Lipid peroxidation in the stomach was assessed using the technique of thiobarbituric acid reactive substances and activity of antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase. Statistical analysis was done with ANOVA - Student-Newman-Keuls (mean ± SE, and P<0.05 was considered as significant. RESULTS: Portal pressure was significantly increased in C + PPVL as compared to the other groups. There was no significant difference in the group of intact rats. TBARS showed significant damage in C and C + PPVL in relation to others. Antioxidant enzymes were significantly increased in the castrated rats with subsequent PPVL as compared to the other groups. CONCLUSION: We suggest that estrogen E2 plays a protective role in intact compared with castrated rats because it presents hydrophenolic radicals in its molecule, thus acting as an antioxidant in this experimental model.

  3. Age-dependent regulation of renal vasopressin V(1A) and V₂ receptors in rats with genetic hypertension: implications for the treatment of hypertension.

    Science.gov (United States)

    Burrell, Louise M; Risvanis, John; Dean, Rachael G; Patel, Sheila K; Velkoska, Elena; Johnston, Colin I

    2013-01-01

    The role of arginine vasopressin (AVP) as a hypertensive hormone remains controversial. We have previously reported that intervention with a V(1A) receptor antagonist in 6-week-old prehypertensive spontaneously hypertensive rats (SHR) for 4 weeks attenuated the subsequent development of hypertension in adult SHR. This study assessed the age-dependent regulation of plasma AVP levels and kidney V(1A) and V₂ receptor expression during the development of hypertension in SHR and in normotensive Sprague Dawley rats. Systolic blood pressure (SBP), plasma AVP, and plasma renin activity (PRA) and kidney V(1A) and V₂ receptor expression were assessed. SHR were studied at three ages: prehypertensive (6 weeks), developed hypertension (10 weeks), and established hypertension (16 weeks). SBP increased with age in SHR (P P P V(1A) receptor gene expression decreased in 10-week and 16-week-old SHR (P V(1A) receptor protein in the inner medulla of 16-week-old SHR (P young SHR. There was no change in V₂ receptor expression during the development of hypertension. In normotensive rats, plasma AVP, PRA, and kidney V(1A) and V₂ receptor expression were unchanged over time. These data suggest that in SHR, activation of plasma AVP and the renal V(1A) receptor occurs during developing hypertension, with downregulation when hypertension is established. The use of V(1A) receptor antagonists in prehypertension may provide a unique opportunity for the prevention of hypertension in high-risk individuals. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  4. AT2 receptors mediate tonic renal medullary vasoconstriction in renovascular hypertension

    Science.gov (United States)

    Duke, Lisa M; Widdop, Robert E; Kett, Michelle M; Evans, Roger G

    2005-01-01

    Renal medullary blood flow is relatively insensitive to angiotensin II (Ang II)-induced vasoconstriction, due partly to AT1-mediated release of nitric oxide and/or prostaglandins. AT2-receptor activation appears to blunt AT1-mediated vasodilatation within the medullary circulation. This could affect long-term efficacy of antihypertensive pharmacotherapies targeting the renin/angiotensin system, particularly in Ang II-dependent forms of hypertension. We tested the effects of AT1- and AT2-receptor blockade on basal cortical and medullary laser Doppler flux (CLDF and MLDF), and on responses to renal arterial infusion of Ang II, in rats with 2 kidney, 1 clip (2K1C) hypertension and sham-operated controls. Studies were carried out in thiobutabarbital (175 mg kg−1, i.p.) anaesthetised rats, 4 weeks after clipping, or sham surgery (n=6 in each of eight groups). Candesartan (10 μg kg−1 h−1, intravenous (i.v.)) reduced mean arterial pressure (∼17%) and increased CLDF (∼24%), similarly in both sham and 2K1C rats, but did not significantly affect MLDF. PD123319 (1 mg kg−1 h−1, i.v.) increased basal MLDF (19%) in 2K1C but not sham rats, without significantly affecting other variables. In sham rats, renal arterial infusion of Ang II (1–100 ng kg−1 min−1) dose dependently decreased CLDF (up to 44%), but did not significantly affect MLDF. These effects were markedly blunted in 2K1C rats. After PD123319, Ang II dose dependently increased MLDF (up to 38%) in sham but not 2K1C rats. Candesartan abolished all effects of Ang II, including those seen after PD123319. Our data indicate that AT1 receptors mediate medullary vasodilatation, which is opposed by AT2-receptor activation. In 2K1C hypertension, AT2-receptor activation tonically constricts the medullary circulation. PMID:15678096

  5. Central inhibitory effect of α-methyldopa on blood pressure, heart rate and body temperature of renal hypertensive rats

    NARCIS (Netherlands)

    Nijkamp, F.P.; Ezer, Joseph; Jong, Wybren de

    The central inhibitory effect of α-methyldopa on blood pressure, heart rate and body temperature was studied in conscious renal hypertensive rats. Systemic administration of α-methyldopa decreased mean arterial blood pressure and body temperature and caused a short lasting increase in heart rate

  6. Response of Renal Podocytes to Excessive Hydrostatic Pressure: a Pathophysiologic Cascade in a Malignant Hypertension Model

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    Ramzia Abu Hamad

    2017-12-01

    Full Text Available Background/Aims: Renal injuries induced by increased intra-glomerular pressure coincide with podocyte detachment from the glomerular basement membrane (GBM. In previous studies, it was demonstrated that mesangial cells have a crucial role in the pathogenesis of malignant hypertension. However, the exact pathophysiological cascade responsible for podocyte detachment and its relationship with mesangial cells has not been fully elucidated yet and this was the aim of the current study. Methods: Rat renal mesangial or podocytes were exposed to high hydrostatic pressure in an in-vitro model of malignant hypertension. The resulted effects on podocyte detachment, apoptosis and expression of podocin and integrinβ1 in addition to Angiotensin-II and TGF-β1 generation were evaluated. To simulate the paracrine effect podocytes were placed in mesangial cell media pre-exposed to pressure, or in media enriched with Angiotensin-II, TGF-β1 or receptor blockers. Results: High pressure resulted in increased Angiotensin-II levels in mesangial and podocyte cells. Angiotensin-II via the AT1 receptors reduced podocin expression and integrinβ1, culminating in detachment of both viable and apoptotic podocytes. Mesangial cells exposed to pressure had a greater increase in Angiotensin-II than pressure-exposed podocytes. The massively increased concentration of Angiotensin-II by mesangial cells, together with increased TGF-β1 production, resulted in increased apoptosis and detachment of non-viable apoptotic podocytes. Unlike the direct effect of pressure on podocytes, the mesangial mediated effects were not related to changes in adhesion proteins expression. Conclusions: Hypertension induces podocyte detachment by autocrine and paracrine effects. In a direct response to pressure, podocytes increase Angiotensin-II levels. This leads, via AT1 receptors, to structural changes in adhesion proteins, culminating in viable podocyte detachment. Paracrine effects of

  7. Renal myogenic constriction protects the kidney from age-related hypertensive renal damage in the Fawn-Hooded rat

    NARCIS (Netherlands)

    Vavrinec, Peter; Henning, Robert H.; Goris, Maaike; Landheer, Sjoerd W.; Buikema, Hendrik; van Dokkum, Richard P. E.

    Introduction:Intact myogenic constriction plays a role in renal blood flow autoregulation and protection against pressure-related (renal) injury. However, to what extent alterations in renal artery myogenic constriction are involved in development of renal damage during aging is unknown. Therefore,

  8. [Clinical effect of arotinolol hydrochloride and its influence on renal function in elderly patients with essential hypertension].

    Science.gov (United States)

    Miyauchi, E; Matsumoto, M; Kimura, Y; Hattori, H; Tsukio, Y; Tsuchiya, H; Takasaki, M; Munehira, J; Yamada, K; Iwai, K; Kawanishi, K; Hoshino, T; Murai, H

    1999-08-01

    Arotinolol hydrochloride with alpha-and beta-receptor blocking action, developed in Japan, is mainly used for the treatment of hypertension. The study population consisted of 42 outpatients with essential hypertension with a blood pressure greater or equal to 160/96 mmHg. 10 men and 32 women, with a mean age of 77.5 year. The patients received 10 mg arotinolol hydrochloride daily for 24 weeks which was taken orally twice a day. We evaluated the changes of blood pressure, heart rate and chief complaints of patients before and every 4 weeks during treatment and the renal function before, 12 weeks after and 24 weeks after, the administration of arotinolol hydrochloride. Blood pressure and heart rate decreased significantly after 4 weeks of treatment with arotinolol hydrochloride (p arotinolol hydrochloride has antihypertensive effects without renal dysfunction in elderly patients with essential hypertension.

  9. Glucagon-like peptide-1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP-1 receptors.

    Science.gov (United States)

    Ronn, Jonas; Jensen, Elisa P; Wewer Albrechtsen, Nicolai J; Holst, Jens Juul; Sorensen, Charlotte M

    2017-12-01

    Glucagon-like peptide-1 (GLP-1) is an incretin hormone increasing postprandial insulin release. GLP-1 also induces diuresis and natriuresis in humans and rodents. The GLP-1 receptor is extensively expressed in the renal vascular tree in normotensive rats where acute GLP-1 treatment leads to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP-1 has been reported both to increase and decrease MAP. The aim of this study was to examine expression of renal GLP-1 receptors in spontaneously hypertensive rats (SHR) and to assess the effect of acute intrarenal infusion of GLP-1. We hypothesized that GLP-1 would increase diuresis and natriuresis and reduce MAP in SHR. Immunohistochemical staining and in situ hybridization for the GLP-1 receptor were used to localize GLP-1 receptors in the kidney. Sevoflurane-anesthetized normotensive Sprague-Dawley rats and SHR received a 20 min intrarenal infusion of GLP-1 and changes in MAP, RBF, heart rate, dieresis, and natriuresis were measured. The vasodilatory effect of GLP-1 was assessed in isolated interlobar arteries from normo- and hypertensive rats. We found no expression of GLP-1 receptors in the kidney from SHR. However, acute intrarenal infusion of GLP-1 increased MAP, RBF, dieresis, and natriuresis without affecting heart rate in both rat strains. These results suggest that the acute renal effects of GLP-1 in SHR are caused either by extrarenal GLP-1 receptors activating other mechanisms (e.g., insulin) to induce the renal changes observed or possibly by an alternative renal GLP-1 receptor. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  10. Experimental depletion of different renal interstitial cell populations

    International Nuclear Information System (INIS)

    Bohman, S.O.; Sundelin, B.; Forsum, U.; Tribukait, B.

    1988-01-01

    To define different populations of renal interstitial cells and investigate some aspects of their function, we studied the kidneys of normal rats and rats with hereditary diabetes insipidus (DI, Brattleboro) after experimental manipulations expected to alter the number of interstitial cells. DI rats showed an almost complete loss of interstitial cells in their renal papillae after treatment with a high dose of vasopressin. In spite of the lack of interstitial cells, the animals concentrated their urine to the same extent as vasopressin-treated normal rats, indicating that the renomedullary interstitial cells do not have an important function in concentrating the urine. The interstitial cells returned nearly to normal within 1 week off vasopressin treatment, suggesting a rapid turnover rate of these cells. To further distinguish different populations of interstitial cells, we studied the distribution of class II MHC antigen expression in the kidneys of normal and bone-marrow depleted Wistar rats. Normal rats had abundant class II antigen-positive interstitial cells in the renal cortex and outer medulla, but not in the inner medulla (papilla). Six days after 1000 rad whole body irradiation, the stainable cells were almost completely lost, but electron microscopic morphometry showed a virtually unchanged volume density of interstitial cells in the cortex and outer medulla, as well as the inner medulla. Thus, irradiation abolished the expression of the class II antigen but caused no significant depletion of interstitial cells

  11. Effects of long-term therapy with arotinolol on blood pressure and renal function in hypertensive patients with chronic renal failure.

    Science.gov (United States)

    Shiigai, T

    1993-01-01

    The effects on blood pressure and renal function of long-term treatment with the alpha- and beta-blocker arotinolol at a dose of 20 mg/day were studied in 10 hypertensive patients with chronic renal failure. Patients received low-protein therapy in which the protein and phosphorus intakes were controlled at a certain level. The average duration of arotinolol treatment was 18.4 months. A significant decrease in blood pressure was seen after the second month of treatment, and this effect continued up to the 20th month. The progression rates of renal failure (creatinine clearance/month) before and after treatment were -0.377 +/- 0.344 and -0.164 +/- 0.172 ml/min/month, respectively. No side effects attributable to the drug were observed. These findings indicate that arotinolol has a stable antihypertensive effect and no adverse effects on renal function. Arotinolol appears to be a useful drug in the long-term treatment of hypertension in patients with chronic renal failure.

  12. Renal dynamic scintigraphy with captropil in systemic arterial hypertension diagnosis; Cintilografia renal dinamica com captopril no diagnostico da hipertensao arterial renovascular

    Energy Technology Data Exchange (ETDEWEB)

    Cervo, Marco Antonio Cadorna; Amarante Junior, Jose Luiz de Medeiros; Souza, Ricardo Alberto Manhaes; Evangelista, Maria Gardenia [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    1995-12-31

    Forty one patients, 15 male and 16 female presenting systemic arterial hypertension were submitted to Basal RDC and after being simulated by Captopril; the radiotracer used was 99 mTc-DTPA (dietileno triamino pentacetic acid-99 Tc-technetium). From the 41 patients studied, 13 had the GFR (Glomerular filtration rate) Captopril when compared to Basal RDC radioactive, 11 of them were confirmed as having vascular renal disease by Renal Artiography and two of them were false (one case renal litiase and the other chronic pyelonephritis). Two more false negative cases have occurred in the RDC and three patients refused to be submitted to a Renal Arteriography. In the cases which the Total Glomerular Filtration Rate was reduced, there was an agreement of 89,5% between the RDC and the Renal Arteriography. No alterations have been observed in the Renal Arteriography on the remaining 23 patients and in the RDC after Captopril there was normal increase in the Glomerular Filtration Rate when compared to the Basal RDC. The method has showed sensitivity of 84% and specificity of 92%. We can conclude that the RDC with Captopril test is not an invasive method, it has good sensitivity and specificity and it can be indicated as a beginning test to select patients when you intend to detect vascular renal disease; nevertheless the RDC will never be used as a final test of vascular lesion. (author) 22 refs., 7 figs., 2 tabs.

  13. Molecular Mechanisms of Curcumin Renoprotection in Experimental Acute Renal Injury

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    Youling Fan

    2017-12-01

    Full Text Available As a highly perfused organ, the kidney is especially sensitive to ischemia and reperfusion. Ischemia-reperfusion (IR-induced acute kidney injury (AKI has a high incidence during the perioperative period in the clinic and is an important link in ischemic acute renal failure (IARF. Therefore, IR-induced AKI has important clinical significance and it is necessary to explore to develop drugs to prevent and alleviate IR-induced AKI. Curcumin [diferuloylmethane, 1,7-bis(4-hydroxy-3-methoxiphenyl-1,6-heptadiene-3,5-dione] is a polyphenol compound derived from Curcuma longa (turmeric and was shown to have a renoprotective effect on ischemia-reperfusion injury (IRI in a previous study. However, the specific mechanisms underlying the protective role of curcumin in IR-induced AKI are not completely understood. APPL1 is a protein coding gene that has been shown to be involved in the crosstalk between the adiponectin-signaling and insulin-signaling pathways. In the study, to investigate the molecular mechanisms of curcumin effects in kidney ischemia/reperfusion model, we observed the effect of curcumin in experimental models of IR-induced AKI and we found that curcumin treatment significantly increased the expression of APPL1 and inhibited the activation of Akt after IR treatment in the kidney. Our in vitro results showed that apoptosis of renal tubular epithelial cells was exacerbated with hypoxia-reoxygenation (HR treatment compared to sham control cells. Curcumin significantly decreased the rate of apoptosis in renal tubular epithelial cells with HR treatment. Moreover, knockdown of APPL1 activated Akt and subsequently aggravated apoptosis in HR-treated renal tubular epithelial cells. Conversely, inhibition of Akt directly reversed the effects of APPL1 knockdown. In summary, our study demonstrated that curcumin mediated upregulation of APPL1 protects against ischemia reperfusion induced AKI by inhibiting Akt phosphorylation.

  14. Renal denervation for refractory hypertension. Technical aspects, complications and radiation exposure

    International Nuclear Information System (INIS)

    Scheurig-Muenkler, C.; Kroencke, T.J.; Powerski, M.J.; Weiss, W.; Toelle, M.; Giet, M. van der; Zidek, W.; Foert, E.

    2013-01-01

    Purpose: To analyze procedural details, complications and radiation exposure in renal denervation (RDN) using the Medtronic Symplicity registered device in the treatment of refractory hypertension. Materials and Methods: Fifty three consecutive patients underwent RDN. The number of ablations per artery, peri-procedural complications, procedure time (PT), fluoroscopy time (FT), dose-area product (DAP) and procedure-related complications were documented. Additionally, the radiation dose was compared between obese (body mass index ≥ 30 kg/m 2 ) and non-obese patients. Results: Bilateral RDN was performed in 50/53 (94 %) cases and with a minimum of 4 ablations per artery in 33/50 (66 %), the mean count being 5.4 (range R: 2 - 13) on the right and 4.3 (R: 1 - 10) on the left. The FT and DAP decreased significantly over the first 12 procedures, reaching a steady state with a median FT of 11.2 min (R: 7.5 - 27) and a median DAP of 4796 cGy x cm 2 (R: 1076 - 21 371), resulting in an effective dose of 15.7 mSv. The median PT was 57 min (R: 40 - 70). Obese patients had a 3.3-fold higher radiation dose (p < 0.001). We observed one severe spasm and one imminent respiratory depression, both resolved without sequelae. Conclusion: For an experienced interventionalist, RDN has a short learning curve with a low risk profile. The radiation dose does not exceed that of other renal artery interventions, but is explicitly higher in obese patients, who account for a large portion of patients with refractory hypertension. (orig.)

  15. Cardiac and renal effects induced by different exercise workloads in renovascular hypertensive rats

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    E.R. Soares

    2011-06-01

    Full Text Available We examined the effect of exercise training (Ex without (Ex 0% or with a 3% workload (Ex 3% on different cardiac and renal parameters in renovascular hypertensive (2K1C male Fisher rats weighing 150-200 g. Ex was performed for 5 weeks, 1 h/day, 5 days/week. Ex 0% or Ex 3% induced similar attenuation of baseline mean arterial pressure (MAP, 119 ± 5 mmHg in 2K1C Ex 0%, N = 6, and 118 ± 5 mmHg in 2K1C Ex 3%, N = 11, vs 99 ± 4 mmHg in sham sedentary (Sham Sed controls, N = 10 and heart rate (HR, bpm (383 ± 13 in 2K1C Ex 0%, N = 6, and 390 ± 14 in 2K1C Ex 3%, N = 11 vs 371 ± 11 in Sham Sed, N = 10,. Ex 0%, but not Ex 3%, improved baroreflex bradycardia (0.26 ± 0.06 ms/mmHg, N = 6, vs 0.09 ± 0.03 ms/mmHg in 2K1C Sed, N = 11. Morphometric evaluation suggested concentric left ventricle hypertrophy in sedentary 2K1C rats. Ex 0% prevented concentric cardiac hypertrophy, increased cardiomyocyte diameter and decreased cardiac vasculature thickness in 2K1C rats. In contrast, in 2K1C, Ex 3% reduced the concentric remodeling and prevented the increase in cardiac vasculature wall thickness, decreased the cardiomyocyte diameter and increased collagen deposition. Renal morphometric analysis showed that Ex 3% induced an increase in vasculature wall thickness and collagen deposition in the left kidney of 2K1C rats. These data suggest that Ex 0% has more beneficial effects than Ex 3% in renovascular hypertensive rats.

  16. Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report.

    Science.gov (United States)

    Park, Sang-Hee; Lee, Yoon-Sook; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

    2014-10-01

    Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis.

  17. The renin-angiotensin system in malignant hypertension revisited: plasma renin activity, microangiopathic hemolysis, and renal failure in malignant hypertension

    NARCIS (Netherlands)

    van den Born, Bert-Jan H.; Koopmans, Richard P.; van Montfrans, Gert A.

    2007-01-01

    BACKGROUND: Malignant hypertension is a renin-dependent form of hypertension. However, the variations in renin-angiotensin system (RAS) activation in malignant hypertension are not completely understood. A proposed mechanism for ongoing RAS activation is the presence of microangiopathic hemolysis

  18. Magnitude of blood pressure reduction in the placebo arms of modern hypertension trials: implications for trials of renal denervation.

    Science.gov (United States)

    Patel, Hitesh C; Hayward, Carl; Ozdemir, Baris Ata; Rosen, Stuart D; Krum, Henry; Lyon, Alexander R; Francis, Darrel P; di Mario, Carlo

    2015-02-01

    Early phase studies of novel interventions for hypertension, such as renal sympathetic denervation, are sometimes single-armed (uncontrolled). We explored the wisdom of this by quantifying the blood pressure fall in the placebo arms of contemporary trials of hypertension. We searched Medline up to June 2014 and identified blinded, randomized trials of hypertension therapy in which the control arm received placebo medication or a sham (placebo) procedure. For nonresistant hypertension, we have identified all such trials of drugs licensed by the US Food and Drug Administration since 2000 (5 drugs). This US Food and Drug Administration-related restriction was not applied to resistant hypertension trials. This produced 7451 patients, who were allocated to a blinded control from 52 trials of nonresistant hypertension and 694 patients from 8 trials of resistant hypertension (3 drugs and 2 interventions). Systolic blood pressure fell by 5.92 mm Hg (95% confidence interval, 5.14-6.71; Pblood pressure monitoring as an inclusion criterion (z=2.84; P=0.0045), in those with higher baseline blood pressures (z=-0.3; P=0.0001), and in those where the patients were prescribed a continuous background of antihypertensives (z=-2.72; P=0.0065). The nontrivial magnitude of these apparent blood pressure reductions with perfectly ineffective intervention (placebo) illustrates that efficacy explorations of novel therapies for hypertension, once safety is established, should be performed with a randomized, appropriately controlled, and blinded design. © 2014 American Heart Association, Inc.

  19. Effects of renal sympathetic denervation on exercise blood pressure, heart rate, and capacity in patients with resistant hypertension.

    Science.gov (United States)

    Ewen, Sebastian; Mahfoud, Felix; Linz, Dominik; Pöss, Janine; Cremers, Bodo; Kindermann, Ingrid; Laufs, Ulrich; Ukena, Christian; Böhm, Michael

    2014-04-01

    Renal denervation reduces office blood pressure in patients with resistant hypertension. This study investigated the effects of renal denervation on blood pressure, heart rate, and chronotropic index at rest, during exercise, and at recovery in 60 patients (renal denervation group=50, control group=10) with resistant hypertension using a standardized bicycle exercise test protocol performed 6 and 12 months after renal denervation. After renal denervation, exercise blood pressure at rest was reduced from 158±3/90±2 to 141±3/84±4 mm Hg (Pblood pressure/P=0.007 for diastolic blood pressure) after 6 months and 139±3/83±4 mm Hg (Pblood pressure tended to be lower at all stages of exercise at 6- and 12-month follow-up in patients undergoing renal denervation, although reaching statistical significance only at mild-to-moderate exercise levels (75-100 W). At recovery after 1 minute, blood pressure decreased from 201±4/95±2 to 177±4/88±2 (Pblood pressure and heart rate during exercise, improved mean workload, and increased exercise time without impairing chronotropic competence.

  20. Potential Cardiovascular and Renal Protective Effects of Vitamin D and Coenzyme Q10in l-NAME-Induced Hypertensive Rats.

    Science.gov (United States)

    Shamardl, Hanan A; El-Ashmony, Sahar M; Kamel, Hala F; Fatani, Sameer H

    2017-08-01

    Hypertension is one of the primary modifiable risk factors for cardiovascular disease. Adequate vitamin D (vit D) levels have been shown to reduce vascular smooth muscle contraction and to increase arterial compliance, which may be beneficial in hypertension. Further, coenzyme Q10 (COQ10) through its action to lower oxidative stress has been reported to have beneficial effects on hypertension and heart failure. This study examined the possible cardiac and renal protective effects of vit D and COQ10 both separately and in combination with an angiotensin II receptor blocker, valsartan (vals) in l-NAME hypertensive rats. Hypertension was induced in rats by l-NAME administration. Following induction of hypertension, the rats were assigned into the following 6 subgroups: an l-NAME alone group and treated groups receiving the following drugs intraperitoneally for 6 weeks; vals, vit D, COQ10 and combination of vals with either vit D or COQ10. A group of normotensive rats were used as negative controls. At the end of the treatment period, blood pressure, serum creatinine, blood urea nitrogen, lipids and serum, cardiac and renal parameters of oxidative stress were measured. Compared to the l-NAME only group, all treatments lowered systolic, diastolic, mean arterial pressure, total cholesterol, low-density lipoprotein cholesterol, and creatinine levels as well as TNF-α and malondialdehyde. Further, the agents increased serum, cardiac and renal total antioxidant capacity. Interestingly, the combination of agents had further effects on all the parameters compared to treatment with each single agent. The study suggests that the additive protective effects of vit D and COQ10 when used alone or concurrent with vals treatment in hypertensive rats may be due to their effects as antioxidants, anticytokines and blood pressure conservers. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  1. Role of measurement of cystatin C in analyzing the results of renal function tests in patients with essential hypertension

    International Nuclear Information System (INIS)

    Zhang Xiaofeng; Lu Hongtai; Dong Yaorong; Xia Jing; Liu Yi

    2003-01-01

    Objective: To explore the use of cystatin C for analysing the results of renal function tests and renal blood flow study in patients with essential hypertension. Methods: The following tests were performed in 62 patients with essential hypertension and 32 controls: plasma cystatin C (with LPET), plasma ET (with RIA), four urinary sensitive parameters for detecting early renal injury i.e. urinary Alb/Cr, NAG/Cr and α-mG/Cr (with ELISA) and renal blood flow study (with Doppler). Results: The patients could be divided into two groups: Cystatin C positive (above normal value, n=23) and cystamin C negative (n=39). Plasma ET levels in cystamin C positive group were significantly higher than those in the 32 controls. Values of the four urinary parameters in the two patient groups were very significantly higher than those in the controls (p<0.01), the difference between the two patient groups was also very significant (p<0.01). Renal arterial blood flow in the two patient groups was much different from that was no significant difference between the two groups themselves. In the patients, with the decrease of GFR, Serum creatinine levels were elevated but urea nitrogen levels remained within normal limit. Conclusion: In the cystamin C negative patients, there was already marked alteration of the renal blood flow through auto-regulation. Although GFR, serum creatinine and urea nitrogen levels remained within normal range, early renal injury, especially tubular ones had been present. As the disease worsened and cystatin levels increased, there was no progressive alteration of renal blood flow. Marked deterioration of renal glomeruli and tubular functions could be detected

  2. Honey Supplementation in Spontaneously Hypertensive Rats Elicits Antihypertensive Effect via Amelioration of Renal Oxidative Stress

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    Omotayo O. Erejuwa

    2012-01-01

    Full Text Available Oxidative stress is implicated in the pathogenesis and/or maintenance of elevated blood pressure in hypertension. This study investigated the effect of honey on elevated systolic blood pressure (SBP in spontaneously hypertensive rats (SHR. It also evaluated the effect of honey on the amelioration of oxidative stress in the kidney of SHR as a possible mechanism of its antihypertensive effect. SHR and Wistar Kyoto (WKY rats were randomly divided into 2 groups and administered distilled water or honey by oral gavage once daily for 12 weeks. The control SHR had significantly higher SBP and renal malondialdehyde (MDA levels than did control WKY. The mRNA expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2 and glutathione S-transferase (GST were significantly downregulated while total antioxidant status (TAS and activities of GST and catalase (CAT were higher in the kidney of control SHR. Honey supplementation significantly reduced SBP and MDA levels in SHR. Honey significantly reduced the activities of GST and CAT while it moderately but insignificantly upregulated the Nrf2 mRNA expression level in the kidney of SHR. These results indicate that Nrf2 expression is impaired in the kidney of SHR. Honey supplementation considerably reduces elevated SBP via amelioration of oxidative stress in the kidney of SHR.

  3. RENOVASCULAR HYPERTENSION DUE TO RENAL ARTERY STENOSIS IN KLIPPEL-FEIL SYNDROME

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    Foyaca-Sibat H. MD.

    2003-01-01

    Full Text Available ABSTRACT We report one patient with Klippel-Feil (KFS syndrome, other associated anomalies, uncontrolled arterial hypertension, and renal artery stenosis. Because this patient underwent for surgical revascularization with unsuccessful result, all proposed way of treatments are revised, and we have hypothesized that probably for patients with KFS and unilateral renal artery stenosis, medical treatment with ACE inhibitors can provide more benefits than surgical revascularization or percutaneous transluminal angioplasty. We considered that those patients should be manage by a team of medical doctors being aware of their common associated anomalies, identifying all of them when it is possible then, making an integral evaluation of the each individual situation for establishing their medical priorities in order, and then address its treatments accordingly. If at this stage any surgical treatment is required, is important to bring those problems to the anesthesiologist’s attention for a very careful manipulation of the neck and head during induction of anesthesia. The final results will be strongly related with the capacity of management of the underlying cardio-respiratory, renal, skeletal, urogenital, and nervous system problems. . We also propose the term of Klippel-Feil syndrome "Plus" for those patients with cervical vertebral fusion and many other associated deformities rather than to add new eponyms to the long list that already exist. _____________ RESUMEN: HIPERTENSION RENOVASCULAR DEBIDO A ESTENOSIS DE LA ARTERIA RENAL EN EL SÍNDROME DE KLIPPEL-FEIL Reportamos un paciente afectado por un syndrome de Klippel-Feil, otras anormalias congenitas, hipertension arterial incontrolada y una estenosis unilateral de la arteria renal. Este paciente fue sometido a un tratamiento quirÚrgico de la estenosis de la arteria renal, cuyos resultados fueron no satisfactorios por lo que revisamos todas las alternativas de tratamiento para la estenosis

  4. ROLE OF CENTRAL HEMODYNAMIC PARAMETERS, INTIMAL MEDIAL THICKNESS AND ENDOTHELIAL DYSFUNCTION IN CHILDREN WITH RENAL ARTERIAL HYPERTENSION

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    I. S. Kostyushina

    2013-01-01

    Full Text Available The increase in arterial hypertension is one of the most sensitive markers of the renal affection grade, including patients without chronic renal diseases; its rate is in inverse proportion to renal functions. Left ventricular hypertrophy development at chronic renal disease results from the development of increased left ventricular afterload and end diastolic pressure influence; it is a compensatory mechanism, which is closely interconnected with mortality from cardiovascular diseases. Echocardiography is the most widely used method of evaluating the condition of central hemodynamics both in adults and children with arterial hypertension. However, echocardiography does not give the researcher any complete presentation of the cardiovascular system’s affection and the consequences of it in the setting of a progressing arterial hypertension. Detection of changes in the arterial wall (intimal medial thickness and endothelial dysfunction is used to estimate the risk of developing such complications. Ultrasonic diagnostics allow to assess the wall’s structure, vascular lumen and determining the intimal medial thickness. Data from a range of foreign and domestic studies allows to suggest that the level of endothelin-1 in the blood serum and its excretion with urine may reflect the renovascular damage severity. The article presents a literary review on the given issue.

  5. Role of angiotensin II type 1a receptor in renal injury induced by deoxycorticosterone acetate-salt hypertension.

    Science.gov (United States)

    Hisamichi, Mikako; Kamijo-Ikemori, Atsuko; Sugaya, Takeshi; Ichikawa, Daisuke; Natsuki, Takayuki; Hoshino, Seiko; Kimura, Kenjiro; Shibagaki, Yugo

    2017-01-01

    The aim of this study was to investigate the in vivo role of angiotensin II type 1a (AT1a) receptor in renal damage as a result of hypertension by using transgenic mice with AT1a receptor gene disruption. Transgenic mice that express human liver-type fatty acid binding protein (L-FABP) with or without disruption of the AT1a receptor gene (L-FABP +/- AT1a -/- , and L-FABP +/- AT1a +/+ , respectively) were used with urinary L-FABP as an indicator of tubulointerstitial damage. Those female mice were administered subcutaneously deoxycorticosterone acetate (DOCA)-salt tablets plus drinking water that contained 1% saline for 28 d after uninephrectomy. In L-FABP +/- AT1a +/+ mice that received DOCA-salt treatment, hypertension was induced and slight expansion of glomerular area, glomerular sclerosis, and tubulointerstitial damage were observed. In L-FABP +/- AT1a -/- mice that received DOCA-salt treatment, hypertension was similarly induced and the degree of glomerular damage was significantly more severe than in L-FABP +/- AT1a +/+ -DOCA mice. Urinary L-FABP levels were significantly higher in L-FABP +/- AT1a -/- -DOCA mice compared with those in L-FABP +/- AT1a +/+ -DOCA mice. Hydralazine treatment significantly attenuated renal damage that was found in L-FABP +/- AT1a -/- -DOCA mice along with a reduction in blood pressure. In summary, activation of the AT1a receptor may contribute to maintenance of the glomerular structure against hypertensive renal damage.-Hisamichi, M., Kamijo-Ikemori, A., Sugaya, T., Ichikawa, D., Natsuki, T., Hoshino, S., Kimura, K., Shibagaki, Y. Role of angiotensin II type 1a receptor in renal injury induced by deoxycorticosterone acetate-salt hypertension. © The Author(s).

  6. Tempol, a superoxide dismutase-mimetic drug, prevents chronic ischemic renal injury in two-kidney, one-clip hypertensive rats.

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    Nunes, Douglas Vq; Costa, Cristiane A; De Bem, Graziele F; Cordeiro, Viviane Sc; Santos, Izabelle B; Carvalho, Lenize Crm; Jordão, Alessandro K; Cunha, Anna C; Ferreira, Vitor F; Moura, Roberto S; Resende, Angela C; Ognibene, Dayane T

    2018-01-23

    Tempol, a superoxide dismutase-mimetic drug, has been shown to attenuate radical-induced damage, exerting beneficial effects in the animal models of oxidative stress and hypertension. This study evaluated the effect of Tempol on renal structural and functional alterations in two-Kidney, one-Clip hypertensive rats. In this study, young male Wistar rats had the left kidney clipped (2K1C), and sham-operated animals (Sham) were used as controls. Animals received Tempol (1mmol/L in drinking water) or vehicle for 5 weeks. Systolic blood pressure was evaluated once a week. At the end of the experimental protocol, the animals were placed in metabolic cages to collect urine (24h) and then anesthetized with thiopental (70mg/kg i.p.) to collect blood by puncturing the descending aorta for biochemical analysis, and the clipped kidney for morphological and immunohistochemical analyses. The vasodilator effect of Tempol was evaluated in mesenteric arterial bed (MAB) isolated from adult Wistar rats. The chronic treatment with Tempol prevented the development of hypertension and the increased plasma levels of urea, creatinine, and 8-isoprostane in 2K1C animals. Tempol also improved both glomeruli number and kidney volume to normal levels in the 2K1C+Tempol group. In addition, the treatment prevented the increased collagen deposition and immunostaining for renin, caspase-3, and 8-isoprostane in the stenotic kidney of 2K1C animals. Moreover, Tempol induced a dose-dependent vasodilator response in MAB from Wistar rats. These results suggest that Tempol protects the stenotic kidney against chronic ischemic renal injury and prevents renal dysfunction in the 2K1C model, probably through its antioxidant, vasodilator and antihypertensive actions.

  7. Renal microvascular disease determines the responses to revascularization in experimental renovascular disease.

    Science.gov (United States)

    Chade, Alejandro R; Kelsen, Silvia

    2010-08-01

    Percutaneous transluminal renal angioplasty (PTRA) is the most frequent therapeutic approach to resolving renal artery stenosis (RAS). However, renal function recovers in only 30% of the cases. The causes of these poor outcomes are still unknown. We hypothesized that preserving the renal microcirculation distal to RAS will improve the responses to PTRA. RAS was induced in 28 pigs. In 14, vascular endothelial growth factor (VEGF)-165 0.05 microg/kg was infused intrarenally (RAS+VEGF). Single-kidney function was assessed in all pigs in vivo using ultrafast CT after 6 weeks. Observation of half of the RAS and RAS+VEGF pigs was completed. The other half underwent PTRA and repeated VEGF, and CT studies were repeated 4 weeks later. Pigs were then euthanized, the stenotic kidney removed, renal microvascular (MV) architecture reconstructed ex vivo using 3D micro-CT, and renal fibrosis quantified. The degree of RAS and hypertension were similar in RAS and RAS+VEGF. Renal function and MV density were decreased in RAS but improved in RAS+VEGF. PTRA largely resolved RAS, but the improvements of hypertension and renal function were greater in RAS+VEGF+PTRA than in RAS+PTRA, accompanied by a 34% increase in MV density and decreased fibrosis. Preservation of the MV architecture and function in the stenotic kidney improved the responses to PTRA, indicating that renal MV integrity plays a role in determining the responses to PTRA. This study indicates that damage and early loss of renal MV is an important determinant of the progression of renal injury in RAS and instigates often irreversible damage.

  8. The use of Metrizamid in experimental renal angiography

    International Nuclear Information System (INIS)

    Pokorny, L.; Kelemen, J.

    1980-01-01

    A possible application of the non-ionizing contrast material metrizamid (Amipaque Vascularsup(R), Amipaquesup(R)) for renal angiography was experimentally investigated in dogs. 1.5, 3, 10 or 25 ml contrast medium was injected into one kidney. The animals were killed immediately, 3 hours, 24 hours, 7 or 28 days after angiography, and the kidneys were histologically investigated. In several cases the angiograms showed small alterations (transitory vasospasm, inhomogeneous spots on the nephrogram). Histology revealed in the initial period a homogeneous, pinkish, protein-like substance in the Bowman capsule and in the lumen of the tubuli, whereas later infiltrations by round cells and local accumulation of connective tissues were found. (L.E.)

  9. Value of renal scintigraphy with captopril test in the exploration of renovascular hypertension: Case report; Apport de la scintigraphie renale avec test au captopril dans l'exploration de l'hypertension arterielle renovasculaire: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Ghfir, I.; Berehou, F.Z.; Ben Rais, N. [Centre Hospitalier Universitaire de Rabat, Hopital Ibn-Sina, Service de Medecine Nucleaire (Morocco)

    2007-08-15

    Introduction Dynamic renal scintigraphy with {sup 99m}Tc-DTPA and captopril test is a non-invasive functional method for the diagnosis of renovascular hypertension. It allows differentiating between hypertension induced by renal arterial stenosis from primary arterial hypertension with an incidental stenosis. Case report A 14-year-old girl, without previous medical history, developed a severe arterial hypertension with cephalalgia and ears buzzing. Auscultation revealed a murmur in the left lumbar pit. Renal angiography objectified a stenosis of the infra renal aorta due to a circumferential parietal thickening associated to renal arteries stenosis more marked in the left side. Dynamic renal scintigraphy after administration of captopril highlighted a marked collapse of the rate of tracer uptake exceeding 40% on the left side with an increase in the time of collecting on the right side testifying a frankly positive test prevailing on the left. A transluminal angioplasty of the left renal artery and a revascularization surgery on the right side were carried out. The evolution was marked by an improvement of blood pressure figures. Discussion Dynamic renal scintigraphy using {sup 99m}Tc-DTPA with captopril test constitutes a non-invasive process with a low dosimetry for the patients. Its principal goal is to affirm the role of renovascular stenosis in the origin of arterial hypertension and to determine which hypertensive patients with renal arterial stenosis can be treated successfully by surgical or endoscopic revascularization of the kidney. (authors)

  10. Trace elements cadmium and zinc in the pathogenesis of experimental hypertension

    International Nuclear Information System (INIS)

    Lockett, C.J.R.

    1980-01-01

    In human kidneys cadmium is bound by a protein, metallothionein, which also contains zinc, and because cadmium apparently competes with zinc on the same binding sites, the cadmium-zinc ratio is particularly important. An increase in this ratio would mean a relative deficiency in zinc which might result in some forms of hypertension in man and animals. Studies were conducted to determine the effect of small amounts of supplementary dietary cadmium on weanling and adult albino rats. Two colonies of rats were examined. The object of this study was to determine if hypertension could be induced and to investigate its effects on renal function and renin levels in these animals. Sodium and potassium levels and balances, renin, angiotensin II, and urea output were therefore estimated in these animals. In order to assess the effect of length of exposure to cadmium in relation to growth and maturation upon blood pressure, experiments were done on a second colony of male weanling rats. Tissue levels of cadmium and zinc, and serum levels of sodium, potassium, chloride, carbon dioxide, urea and urate were measured. All supplemented diets caused hypertension and a significant drop in urinary urea excretion levels. Plasma angiotensin in males, and renal cadmium-zinc ratios were higher than in controls. The results of the studies in adult rats showed slight sodium and water retention. Weanlings showed a more rapid uptake of cadmium and reached higher blood pressure levels. In conclusion, cadmium does seem to be a factor in selected animal hypertension. A possible mechanism is via interference with renal function, and our data regarding urea output support the idea of renal function impairment. The initiation of a renin-angiotensin hypertension is suggested by the raised angiotensin levels which were detected

  11. Role of 20-hydroxyeicosatetraenoic acid in mediating hypertension in response to chronic renal medullary endothelin type B receptor blockade.

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    Joshua S Speed

    Full Text Available BACKGROUND: The renal medullary endothelin (ET-1 system plays an important role in the control of sodium excretion and arterial pressure (AP through the activation of renal medullary ET-B receptors. We have previously shown that blockade of endothelin type B receptors (ET-B leads to salt-sensitive hypertension through mechanisms that are not fully understood. One possible mechanism is through a reduction in renal medullary production of 20-hydroxyeicosatetraenoic acid (20-HETE. 20-HETE, a metabolite of arachidonic acid, has natriuretic properties similar to ET-B activation. While these findings suggest a possible interaction between ET-B receptor activation and 20-HETE production, it is unknown whether blockade of medullary ET-B receptors in rats maintained on a high sodium intake leads to reductions in 20-HETE production. METHODOLOGY/PRINCIPAL FINDINGS: The effect of increasing sodium intake from low (NS = .8% to high (HS = 8% on renal medullary production of 20-HETE in the presence and absence of renal medullary ET-B receptor antagonism was examined. Renal medullary blockade of ET-B receptors resulted in salt sensitive hypertension. In control rats, blood pressure rose from 112.8±2.4 mmHg (NS to 120.7±9.3 mmHg (HS. In contrast, when treated with an ET-B receptor blocker, blood pressure was significantly elevated from 123.7±3.2 (NS to 164.2±7.1 (HS. Furthermore, increasing sodium intake was associated with elevated medullary 20-HETE (5.6±.8 in NS vs. 14.3±3.7 pg/mg in HS, an effect that was completely abolished by renal medullary ET-B receptor blockade (4.9±.8 for NS and 4.5±.6 pg/mg for HS. Finally, the hypertensive response to intramedullary ET-B receptor blockade was blunted in rats pretreated with a specific 20-HETE synthesis inhibitor. CONCLUSION: These data suggest that increases in renal medullary production of 20-HETE associated with elevating salt intake may be, in part, due to ET-B receptor activation within the renal

  12. Renal response to an acute protein challenge in pregnant women with borderline hypertension.

    Science.gov (United States)

    Heguilén, Ricardo M; Liste, A Andres; Bellusci, Angel D; Lapidus, Alicia M; Bernasconi, Amelia R

    2007-06-01

    The renal reserve (RR), assessed after an oral protein challenge or the intravenous administration of amino acids, is still present in healthy pregnant women (NP), although resting glomerular filtration rate (GFR) and renal plasma flow (RPF) increase progressively throughout normal gestation. No studies have addressed this issue in hypertensive gravidas; the aim of this trial was to evaluate renal response to an acute protein load (PL) in NP and pregnant women with borderline hypertension (HP). Five NP, eight HP and eight healthy non-pregnant women (CG) were evaluated. After fasting overnight, all subjects received an oral water load (20 mL/kg of body weight), the urinary output was then replaced orally with equal volumes of water. After two 30 min periods, an 80 g PL was provided. Creatinine clearance (CCr) was measured every 30 min from 1 h before and for 4 h following PL. Participants remained recumbent during the study, bladder emptiness was assessed by ultrasound immediately after each micturition. Baseline CCr was taken as the average of two 30 min periods before PL and peak Ccr as the maximal CCr recorded thereafter. The groups were similar with regard to age, weight or gestation age. Baseline CCr (NP: 118.5+/-6.0, HP: 127.4+/-6.7 and CG: 99.8+/-2.9 mL/min, P=0.004 (CG vs NP and HP), increased after PL to NP: 223.5+/-9.8 to HP: 178.5+/-13 and to CG: 149.1+/-4.0 mL/min, Pvs HP, CG vs NP and NP vs HP)). Peak minus baseline CCr was 97.3+/-10.1; 46.3+/-12.7 and 48.3+/-4.8 for NP, HP and CG, respectively (Pvs CG and NP). The peak CCr was obtained significantly earlier in both pregnant groups (Period 3) compared with the healthy non-pregnant women (Period 5) (P=0.02). The fractional proximal reabsorption of sodium (FPRNa+) at peak CCr was similar in the groups (NP: 0.74+/-0.01 HP: 0.78+/-0.02 and CG: 0.74+/-0.03, P=not significant (NS)) as was the distal delivery of sodium (DDNa+) (NP: 5.8+/-0.5; HP: 4.1+/-0.5 and CG: 4.3+/-0.4 meq/min, P=NS). Fractional excretion

  13. Urinary magnesium excretion and risk of hypertension: the prevention of renal and vascular end-stage disease study.

    Science.gov (United States)

    Joosten, Michel M; Gansevoort, Ron T; Mukamal, Kenneth J; Kootstra-Ros, Jenny E; Feskens, Edith J M; Geleijnse, Johanna M; Navis, Gerjan; Bakker, Stephan J L

    2013-06-01

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this association. We examined 5511 participants aged 28 to 75 years free of hypertension in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study, a prospective population-based cohort study. Circulating magnesium was measured in plasma and urinary magnesium in two 24-hour urine collections, both at baseline. Incident hypertension was defined as blood pressure ≥140 mm Hg systolic or ≥90 mm Hg diastolic, or initiation of antihypertensive medication. During a median follow-up of 7.6 years (interquartile range, 5.0-9.3 years), 1172 participants developed hypertension. The median urinary magnesium excretion was 3.8 mmol/24 hour (interquartile range, 2.9-4.8 mmol/24 hour). Urinary magnesium excretion was associated with risk of hypertension in an inverse log-linear fashion, and this association remained after adjustment for age, sex, body mass index, smoking status, alcohol intake, parental history of hypertension, and urinary excretion of sodium, potassium, and calcium. Each 1-unit increment in ln-transformed urinary magnesium excretion was associated with a 21% lower risk of hypertension after multivariable adjustment (adjusted hazard ratio, 0.79; 95% confidence interval, 0.71-0.88). No associations were observed between circulating magnesium and risk of hypertension. In conclusion, in this cohort of men and women, urinary magnesium excretion was inversely associated with risk of hypertension across the entire range of habitual dietary intake.

  14. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

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    Okada, Takuya, E-mail: okabone@gmail.com; Pellerin, Olivier [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France); Savard, Sébastien [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Curis, Emmanuel; Monge, Matthieu [INSERM, Clinical Investigation Center 9201 (France); Frank, Michael; Bobrie, Guillaume [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Yamaguchi, Masato; Sugimoto, Koji [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Plouin, Pierre-François; Azizi, Michel [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Sapoval, Marc [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France)

    2015-02-15

    PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.

  15. Experimental gestational hypothyroidism evokes hypertension in adult offspring rats.

    Science.gov (United States)

    Santos, Sheyla Oliveira; Loureiro, Saulo Makerran Araújo; Alves, Iura Gonzalez Nogueira; Jesus, Camila Santos de; Santos, Patrícia Rabelo dos; Santos, Márcio Roberto Viana dos; Dias, Daniel Penteado Martins; Santana-Filho, Valter Joviniano; Badauê-Passos, Daniel

    2012-09-25

    Gestational hypothyroidism is a prevalent disorder in pregnant women. We aimed to investigate the impact of experimental gestational hypothyroidism (EGH) on cardiovascular and autonomic nervous systems (ANS) in the offspring of rats. EGH was induced with methimazole (MMI) 0.02% in drinking water from day 9 of gestation until birth. Sixty day old offspring from MMI-treated dams (OMTD, n=13) or water-treated dams (OWTD, n=13) had femoral arteries surgically assessed for the measurements of heart rate (HR), mean (MAP), systolic (SAP) and diastolic arterial pressure (DAP), and spontaneous baroreflex sensitivity (BRS). To investigate the balance of ANS, we established the high (HF) and low frequency (LF) bands of pulse interval (PI) and LF band of SAP spectrum. OMTD had increased MAP (130.2 ± 2.0 vs 108.8 ± 3.0 mmHg, p<0.001), SAP (157.3 ± 2.9 vs 135.7 ± 4.5mm Hg, p<0.001) and DAP (109.7 ± 1.9 vs 88.4 ± 2.6 mmHg, p<0.001) when compared to OWTD, and had lower HR (355.1 ± 8.9 vs 386.8 ± 9.2 bpm, p<0.05). After spectral analysis of PI and SAP, only LF band of SAP spectrum was higher (7.2 ± 0.8 vs 4.0 ± 0.6 mmHg(2), p<0.01) in OMTD under spontaneous condition. Despite bradycardia, EGH promotes spontaneous hypertension in 60 day old offspring, probably due to increased sympathetic modulation of vessels, which is suggested by the higher LF of SAP. These findings suggest a critical role of maternal THs in the development of fetal cardiovascular and autonomic nervous systems. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  16. Effects of digoxin-specific antibody Fab fragment (Digibind) on blood pressure and renal water-sodium metabolism in 5/6 reduced renal mass hypertensive rats.

    Science.gov (United States)

    Kaide, J; Ura, N; Torii, T; Nakagawa, M; Takada, T; Shimamoto, K

    1999-06-01

    The importance of increased endogenous digitalis-like factor (EDLF) in volume-expanded hypertension has been generally agreed. To further clarify the role of EDLF on the development of hypertension and renal water-sodium handling in 5/6 reduced renal mass hypertensive rats (RRM), we studied the effects of acute administration of digoxin-specific antibody Fab fragment (Digibind) in the early phase and the chronic phase of hypertension in RRM. RRM and sham-operated rats were given 1% saline for 1 or 4 weeks. RRM were injected Digibind (60 mg/kg) or vehicle (0.9% saline) intravenously in the first or fourth week under thiobutabarbital anesthesia. All sham-operated rats were administered Digibind under the same condition. Digibind altered neither blood pressure, heart rate, urine volume, nor urinary sodium excretion in sham-operated rats. However, Digibind produced a gradual but significant decline in mean arterial pressure to the level slightly above that in sham-operated rats from 153 +/- 5 to 131 +/- 5 mm Hg in the first week and from 181 +/- 6 to 129 +/- 4 mm Hg in the fourth week without any significant change in heart rate. The decrease in mean arterial pressure at 160 min after Digibind administration in the fourth week (-48 +/- 5 mm Hg) was greater than that in the first week (-22 +/- 4 mm Hg). No differences were observed in urine volume, urinary sodium excretion, or plasma norepinephrine concentration between Digibind and vehicle-treated RRM in either week. These data suggest that EDLF would contribute to both the early and chronic phase in the development of hypertension in RRM.

  17. The Antihypertensive Effects of Hydroalcoholic Extract of Allium Eriophyllum Leaves on Rats with Simultaneous Type 2 Diabetes and Renal Hypertension

    Directory of Open Access Journals (Sweden)

    Masoud Mozafari

    2015-03-01

    Full Text Available Background: Some species of Allium family are known to have antihypertensive, anti-diabetic, and lipid lowering effects. Objectives: This study aimed to examine the possible mechanisms of antihypertensive, anti-diabetic, and anti-lipid activities of Allium eriophyllum which grows in Fars province, Iran in a rat model of simultaneous type 2 diabetes and renal hypertension. Materials and Methods: This study was conducted on six groups of male Spargue-Dawley rats each containing 8 - 10 animals, including a sham-control, a diabetic, a renal hypertensive, and three simultaneously hypertensive–diabetic groups receiving vehicle or 30 or 100 mg/kg/day hydroalcoholic extract of Allium eriophyllum. Four weeks after induction of diabetes, renal hypertension was induced and the animals started receiving the vehicle or extract for the subsequent four weeks. Afterwards, blood pressure, fasting blood sugar, serum cholesterol, triglyceride, and markers of oxidative stress were measured, and isolated studies were performed on aortic rings. Results: Systolic blood pressure, heart rate, fasting blood sugar, maximal response, and effective concentrations 50 (EC50 of phenylephrine and acetylcholine of the hypertensive-diabetic group receiving vehicle were significantly higher compared to those of the sham-control group, and treatment with the extract led to a significant reduction in these variables. Moreover, serum superoxide dismutase and glutathione reductase and maximal response of acetylcholine were significantly lower in the hypertensive-diabetic group receiving vehicle in comparison to the sham-control group, and treatment with the extract significantly reduced these variables. Conclusions: The present study findings indicated that antihypertensive, anti-diabetic, and anti-lipid effects of the extract might be partly due to its antioxidant mechanism. It was also revealed that its antihypertensive effects may be additionally mediated by improving the release

  18. N-terminal pro-brain natriuretic peptide and renal insufficiency as predictors of mortality in pulmonary hypertension.

    Science.gov (United States)

    Leuchte, Hanno H; El Nounou, Michal; Tuerpe, Juergen Christian; Hartmann, Bertram; Baumgartner, Rainer A; Vogeser, Michael; Muehling, Olaf; Behr, Jürgen

    2007-02-01

    N-terminal pro-brain natriuretic peptide (NT-proBNP) is a byproduct of the brain natriuretic peptide (BNP) that was shown to be of prognostic value in pulmonary hypertension (PH). The role of NT-proBNP in PH has to be determined, especially under the influence of renal impairment that might lead to an accumulation of the peptide, and may be a sign of increased mortality per se. We assessed NT-proBNP, BNP, renal function, and hemodynamic parameters (during right-heart catheterization) in 118 consecutive patients with isolated PH, excluding left-heart disease. Depending on the calculated creatinine clearance, patients were classified into different groups of renal function. Correlation analysis was performed on all key parameters. Results were then compared between the levels of renal function. The prognostic value of each parameter was assessed during a mean follow-up period of 10 months. Twenty-two patients (approximately 19%) had significantly impaired renal function (creatinine clearance < 60 mL/min). Although the overall levels of NT-proBNP were correlated with hemodynamics, we observed no correlation in the group with significant renal dysfunction. Moreover, NT-proBNP was related to creatinine clearance. Finally, NT-proBNP and renal insufficiency were independent predictors of death during univariate and multivariate analysis, whereas BNP only predicted mortality in univariate analysis. The diagnostic accuracy of NT-proBNP as a parameter of the hemodynamic status is diminished by renal function. However, NT-proBNP could be superior to BNP as a survival parameter in PH because it integrates hemodynamic impairment and renal insufficiency, which serves as a sign of increased mortality per se.

  19. Renal denervation for mild-moderate treatment-resistant hypertension : A timely intervention?

    Science.gov (United States)

    Chen, S; Kiuchi, M G; Schmidt, B; Hoye, N A; Acou, W-J; Liu, S; Chun, K R J; Pürerfellner, H

    2017-12-18

    Renal denervation (RDN) has been proposed as a novel antihypertensive intervention for treating resistant hypertension. It remains to be investigated which patient groups can potentially benefit from RDN. The present study aimed to evaluate the efficacy and safety of RDN in patients with mild-moderate resistant hypertension, i. e., systolic office blood pressure (BP) of 140-160 mm Hg despite treatment with three antihypertensive drugs including one diuretic, or mean systolic BP by ambulatory BP monitoring (ABPM) of 135-150 mm Hg. We evaluated data from four relevant clinical studies, all conducted in Europe, comprising 185 eligible patients. The patients' age was 62.1 ± 10.3 years and 73% were male (RDN group n = 149, control group n = 36). A self-control comparison showed that RDN led to significantly reduced ABPM at the 6‑month follow-up (systolic ABPM: 147.3 ± 13.4 mm Hg vs. 136.9 ± 15.5 mm Hg; diastolic ABPM: 81.1 ± 9.6 mm Hg vs. 76.2 ± 9.7 mm Hg; p ABPM as compared with that in the control group (∆systolic-ABPM: -10.4 ± 9.4 vs. -3.5 ± 9.6 mm Hg, p ABPM: -5 ± 5.8 vs. -2.1 ± 5.5 mm Hg; p = 0.005, respectively). The decrease of office BP in the RDN group was also statistically significant. RDN led to a reduced number of antihypertensive medications. No severe adverse events were found during follow-up. Regression analysis showed that the available baseline characteristics did not correlate with the ABPM improvement after RDN. RDN appears to be a safe and effective intervention for patients with mild-moderate resistant hypertension; however, randomized studies are warranted.

  20. Treatment of Hypertension in Renal Transplant Recipients in Four Independent Cross-Sectional Analyses

    Directory of Open Access Journals (Sweden)

    Izabella Kuźmiuk-Glembin

    2018-01-01

    Full Text Available Background/Aims: This retrospective study analysed hypertension management and adherence to blood pressure (BP targets among renal transplant recipients (RTRs under specialized care in the Outpatient Transplantation Unit in the Department of Nephrology, Transplantology and Internal Medicine at Gdansk University Hospital. Methods: Medical records of 101, 316, 639 and 818 RTRs diagnosed with hypertension, who received outpatient care in 2001, 2006, 2011 and 2014, respectively were analysed in four independent cross-sectional surveys. All RTRs received antihypertensive regimens. Results: The overall most commonly used antihypertensive agents were beta-blockers (BB (range 66.3-82.5% followed by calcium channel blockers (CCB (range 52.8-64.2%. Whilst a significant, upward tendency of BB usage (p<0.01 was observed, CCB usage (p<0.001 displayed a downward tendency as a first line therapy in the subsequent years. The average number of antihypertensive agents used per patient increased significantly from 2.24±1.03 in 2001 to 2.55±1.25 in 2014 (p<0.05. The most frequently used combination of hypotensive therapy consisted of two or three antihypertensive drugs depending on the survey. The most common two drug combination consisted of BB and CCB followed by BB accompanied by angiotensin converting enzyme inhibitors. A significant, upward tendency in the use of four (p<0.001 and five (p<0.05 antihypertensive drugs simultaneously, was observed in subsequent years. The target values of BP i.e. <140/90 mmHg were accomplished in 47, 58, 60 and 46% of RTRs in subsequent years. In a secondary - stratified analysis of data from 2014, younger patients (p<0.05, patients with better graft function (p<0.001, patients treated with a higher number of antihypertensive agents (p<0.001 and those not treated with BB (p<0.01 were shown to reach the BP target of below 140/90 mmHg more often. Conclusion: The study showed intensification of hypertension treatment in RTRs in

  1. An experimental study on renal arterial and parenchymal change caused by selective renal infusion of epinephrine

    International Nuclear Information System (INIS)

    Jeon, Seok Chol; Yeon, Kyung Mo; Han, Man Chung

    1981-01-01

    Selective infusion of the epinephrine into the renal artery has been used in the field of the diagnostic and the therapeutic radiology for correct diagnosis and effective treatment, respectively. However, administration of overdose of epinephrine may cause serious complication, renal infarction. The study was undertaken to evaluate the sequential change of renal arterial constrictive effect of selective infusion of epinephrine into renal artery and to determine the critical doses of epinephrine producing irreversible renal infarct. A total of 25 rabbits are used, which are divided into 5 groups. Under the general anesthesia is made the selective infusion of various doses of epinephrine into the right renal artery of the rabbits. At the various time interval during and after the epinephrine infusion, renal angiography was done, and 24 hrs. later, gross and microscopic findings of the kidney were observed. The results are as follows; 1. Vasoconstriction of renal artery occurred within 2 mins. infusion, and maximum effect within 5 mins. 2. It seems that there is correlation between the amount of infused epinephrine and the time taken to recover from constriction of renal artery. 3. When epinephrine is infused into the renal artery in the rate of 1 ug/min., renal infarct is not noticed below the level of 10 mins., but correlation between the amount of infused epinephrine and the frequency of renal infarct occurs above 20 mins. infusion

  2. The cytochrome P-450 inhibitor cobalt chloride prevents inhibition of renal Na,K-ATPase and redistribution of apical NHE-3 during acute hypertension

    DEFF Research Database (Denmark)

    Zhang, Y B; Magyar, C E; Holstein-Rathlou, N H

    1998-01-01

    by cobalt chloride (CoCl2). Four groups of rats (n = 4 to 5) were studied: (1) sham-operated; (2) 50 mg of CoCl2/kg subcutaneously for 2 d; (3) acute hypertension by constricting arteries for 5 min; and (4) acute hypertension after CoCl2 treatment as in group 3. Renal cortex was analyzed after sorbitol...

  3. A follow-up study of hypertensive patients after operative treatment of unilateral renovascular or renal disease

    DEFF Research Database (Denmark)

    McNair, A; Nielsen, M D; Gammelgaard, P A

    1979-01-01

    A study of 44 hypertensive patients with unilateral renovascular or renal parenchymal disease is presented. All patients underwent corrective surgery. Out of the 44 operated patients, five did not participate in the follow-up examination. The remaining 39 patients constitute the study population....... The effects of surgery on the hypertensive state could be evaluated in 35 patients, whereas four died less than two months after the operation. Follow-up studies were carried out at 8-60 months after the operation. The average period of observation was 32 months; 24 patients were observed for more than two...... years. As a group, the patients had severe hypertension with extensive target organ damage and widespread atherosclerosis. A fairly rigorous selection process was applied, and an unsatisfactory response to medical management was considered a point of major importance. In the majority of cases...

  4. Adherence to Antihypertensive Treatment and the Blood Pressure-Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial.

    Science.gov (United States)

    Azizi, Michel; Pereira, Helena; Hamdidouche, Idir; Gosse, Philippe; Monge, Matthieu; Bobrie, Guillaume; Delsart, Pascal; Mounier-Véhier, Claire; Courand, Pierre-Yves; Lantelme, Pierre; Denolle, Thierry; Dourmap-Collas, Caroline; Girerd, Xavier; Michel Halimi, Jean; Zannad, Faiez; Ormezzano, Olivier; Vaïsse, Bernard; Herpin, Daniel; Ribstein, Jean; Chamontin, Bernard; Mourad, Jean-Jacques; Ferrari, Emile; Plouin, Pierre-François; Jullien, Vincent; Sapoval, Marc; Chatellier, Gilles

    2016-09-20

    The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure-lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control. One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients. The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (P=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was -6.7 mm Hg (P=0.0461) in fully adherent and -7.8 mm Hg (P=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients. In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in

  5. Renal Branch Artery Occlusion in a 13-Year-Old Hypertensive Girl: Initial Treatment and Treatment of Recurrent Stenosis by Balloon Angioplasty

    International Nuclear Information System (INIS)

    Konez, Orhan; Burrows, Patricia E.; Harmon, William E.

    2001-01-01

    A 13-year-old girl who recently developed hypertension was diagnosed to have an occluded right renal branch artery and was treated successfully with percutaneous transluminal angioplasty (PTA). To our knowledge, PTA has not been reported as a treatment for totally occluded renal branch arteries, and there is no data available regarding the success rate and possible complications

  6. Renal versus splenic maximum slope based perfusion CT modelling in patients with portal-hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Brehmer, Katharina [Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden); Svensson, Anders; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden)

    2016-11-15

    To assess liver perfusion-CT (P-CT) parameters derived from peak-splenic (PSE) versus peak-renal enhancement (PRE) maximum slope-based modelling in different levels of portal-venous hypertension (PVH). Twenty-four patients (16 men; mean age 68 ± 10 years) who underwent dynamic P-CT for detection of hepatocellular carcinoma (HCC) were retrospectively divided into three groups: (1) without PVH (n = 8), (2) with PVH (n = 8), (3) with PVH and thrombosis (n = 8). Time to PSE and PRE and arterial liver perfusion (ALP), portal-venous liver perfusion (PLP) and hepatic perfusion-index (HPI) of the liver and HCC derived from PSE- versus PRE-based modelling were compared between the groups. Time to PSE was significantly longer in PVH groups 2 and 3 (P = 0.02), whereas PRE was similar in groups 1, 2 and 3 (P > 0.05). In group 1, liver and HCC perfusion parameters were similar for PSE- and PRE-based modelling (all P > 0.05), whereas significant differences were seen for PLP and HPI (liver only) in group 2 and ALP in group 3 (all P < 0.05). PSE is delayed in patients with PVH, resulting in a miscalculation of PSE-based P-CT parameters. Maximum slope-based P-CT might be improved by replacing PSE with PRE-modelling, whereas the difference between PSE and PRE might serve as a non-invasive biomarker of PVH. (orig.)

  7. The effect of renal denervation on kidney oxygenation as determined by BOLD MRI in patients with hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Vink, E.E.; Boer, A.; Blankestijn, P.J. [University Medical Center Utrecht, Department of Nephrology, P.O. Box 85500, GA, Utrecht (Netherlands); Verloop, W.L.; Voskuil, M. [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Spiering, W.; Leiner, T. [University Medical Center Utrecht, Department of Vascular Medicine, Utrecht (Netherlands); Vonken, E.; Hoogduin, J.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Bots, M.L. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands)

    2015-07-15

    Renal denervation (RDN) is a promising therapy for resistant hypertension. RDN is assumed to decrease sympathetic activity. Consequently, RDN can potentially increase renal oxygenation. Blood oxygen level-dependent MRI (BOLD-MRI) provides a non-invasive tool to determine renal oxygenation in humans. The aim of the current study was to investigate the effect of RDN on renal oxygenation as determined by BOLD-MRI. Patients with resistant hypertension or the inability to follow a stable drug regimen due to unacceptable side effects were included. BOLD-MRI was performed before and 12 months after RDN. Twenty-seven patients were imaged on 3 T and 19 on 1.5 T clinical MRI systems. Fifty-four patients were included, 46 patients (23 men, mean age 57 years) completed the study. Mean 24-h BP changed from 163(±20)/98(±14) mmHg to 154(±22)/92(±13) mmHg (p = 0.001 and p < 0.001). eGFR did not change after RDN [77(±18) vs. 79(±20) mL/min/1.73 m{sup 2}; p = 0.13]. RDN did not affect renal oxygenation [1.5 T: cortical R2*: 12.5(±0.9) vs. 12.5(±0.9), p = 0.94; medullary R2*: 19.6(±1.7) vs. 19.3(1.4), p = 0.40; 3 T: cortical R2*: 18.1(±0.8) vs. 17.8(±1.2), p = 0.47; medullary R2*: 27.4(±1.9) vs. 26.7(±1.8), p = 0.19]. The current study shows that RDN does not lead to changes in renal oxygenation 1 year after RDN as determined by BOLD-MRI. (orig.)

  8. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment...... with a calcium channel blocker or to treatment with a combination of these drugs. The aim of the study was to evaluate the rate of decline in GFR in patients with chronic renal failure and hypertension treated with isradipine and spirapril as monotherapy and in combination....

  9. Subclinical Kidney Damage in Hypertensive Patients: A Renal Window Opened on the Cardiovascular System. Focus on Microalbuminuria.

    Science.gov (United States)

    Mulè, Giuseppe; Castiglia, Antonella; Cusumano, Claudia; Scaduto, Emilia; Geraci, Giulio; Altieri, Dario; Di Natale, Epifanio; Cacciatore, Onofrio; Cerasola, Giovanni; Cottone, Santina

    2017-01-01

    The kidney is one of the major target organs of hypertension.Kidney damage represents a frequent event in the course of hypertension and arterial hypertension is one of the leading causes of end-stage renal disease (ESRD).ESRD has long been recognized as a strong predictor of cardiovascular (CV) morbidity and mortality. However, over the past 20 years a large and consistent body of evidence has been produced suggesting that CV risk progressively increases as the estimated glomerular filtration rate (eGFR) declines and is already significantly elevated even in the earliest stages of renal damage. Data was supported by the very large collaborative meta-analysis of the Chronic Kidney Disease Prognosis Consortium, which provided undisputable evidence that there is an inverse association between eGFR and CV risk. It is important to remember that in evaluating CV disease using renal parameters, GFR should be assessed simultaneously with albuminuria.Indeed, data from the same meta-analysis indicate that also increased urinary albumin levels or proteinuria carry an increased risk of all-cause and CV mortality. Thus, lower eGFR and higher urinary albumin values are not only predictors of progressive kidney failure, but also of all-cause and CV mortality, independent of each other and of traditional CV risk factors.Although subjects with ESRD are at the highest risk of CV diseases, there will likely be more events in subjects with mil-to-moderate renal dysfunction, because of its much higher prevalence.These findings are even more noteworthy when one considers that a mild reduction in renal function is very common in hypertensive patients.The current European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines for the management of arterial hypertension recommend to sought in every patient signs of subclinical (or asymptomatic) renal damage. This was defined by the detection of eGFR between 30 mL/min/1.73 m 2 and 60 mL/min/1.73 m 2 or the

  10. Effect of high saturated free fatty acids feeding on progression of renal failure in rat model of experimental nephrotoxicity

    Directory of Open Access Journals (Sweden)

    Zaid O. Ibraheem

    2012-02-01

    Full Text Available The current study evaluates the impact of high saturated fat feeding in rat model of experimental nephrotoxicity induced by gentamicin. Sprague-Dawley rats weighing 200 g were randomized into four groups; the first one received the standard rodents chow for 8 weeks and was treated as control, the second group (HFDreceived an experimental high fat diet rich in palm kernel oil (40% of Calories as fat for the same period. The third group (HFDG was given 80 mg/kg (body weight/day gentamicin sulphate intraperitoneally during the last 24 days of the feeding period while the fourth group was given gentamicin as above along with the standard rodents chow. Renal function was assessed through measuring serum creatinine, creatinine clearance and absolute and fractional excretion of both sodium and potassium. At the end, rats underwent a surgical procedure for blood pressure measurement. Renal function study showed a stronger nephrotoxicity for HFDG group. Hypertension was observed in HFD group while the pressure declined after gentamicin co-administration. Overall, changing the feeding behavior toward using more SAFFAs for rats injected with gentamicin promotes the progression of renal failure.

  11. Twenty-Four-Hour Blood Pressure Monitoring to Predict and Assess Impact of Renal Denervation: The DENERHTN Study (Renal Denervation for Hypertension).

    Science.gov (United States)

    Gosse, Philippe; Cremer, Antoine; Pereira, Helena; Bobrie, Guillaume; Chatellier, Gilles; Chamontin, Bernard; Courand, Pierre-Yves; Delsart, Pascal; Denolle, Thierry; Dourmap, Caroline; Ferrari, Emile; Girerd, Xavier; Michel Halimi, Jean; Herpin, Daniel; Lantelme, Pierre; Monge, Matthieu; Mounier-Vehier, Claire; Mourad, Jean-Jacques; Ormezzano, Olivier; Ribstein, Jean; Rossignol, Patrick; Sapoval, Marc; Vaïsse, Bernard; Zannad, Faiez; Azizi, Michel

    2017-03-01

    The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control). Average and standard deviation of 24-hour, daytime, and nighttime BP and the smoothness index were calculated on recordings performed at randomization and 6 months. Responders were defined as a 6-month 24-hour systolic BP reduction ≥20 mm Hg. Analyses were performed on the per-protocol population. The significantly greater BP reduction in the denervation group was associated with a higher smoothness index ( P =0.02). Variability of 24-hour, daytime, and nighttime BP did not change significantly from baseline to 6 months in both groups. The number of responders was greater in the denervation (20/44, 44.5%) than in the control group (11/53, 20.8%; P =0.01). In the discriminant analysis, baseline average nighttime systolic BP and standard deviation were significant predictors of the systolic BP response in the denervation group only, allowing adequate responder classification of 70% of the patients. Our results show that denervation lowers ambulatory BP homogeneously over 24 hours in patients with resistant hypertension and suggest that nighttime systolic BP and variability are predictors of the BP response to denervation. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01570777. © 2017 American Heart Association, Inc.

  12. Renal scintigraphy with captopril for the investigation of arterial hypertension. Captopril-Nierenfunktionsszintigraphie (C-NFSZ) bei der Abklaerung der arteriellen Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Nitzsche, E.; Strauss, E.; Moser, E. (Freiburg Univ. (Germany, F.R.). Abt. Klinische Nuklearmedizin); Grosser, G. (Freiburg Univ. (Germany, F.R.). Abt. Roentgendiagnostik Sankt Marienkrankenhaus, Frankfurt am Main (Germany, F.R.). Radiologische Abt.); Rump, C.; Keller, E. (Freiburg Univ. (Germany, F.R.). Abt. Nephrologie); Meyer, E. (Freiburg Univ. (Germany, F.R.). Abt. Roentgendiagnostik)

    1991-03-01

    Renal artery stenosis (RAS) is a rare cause of hypertension. Radiological tests can disclose the morphological changes, but not their functional effect on renal function and perfusion. Normalization of the blood pressure can be achieved by intervention (operation, percutaneous transluminal renal angiography; PTRA), in cases of prolonged RAS-induced hypertension long-term preservation of the organ function is most important. The purpose of this study was the validation of captopril renography as a screening test for hypertension secondary to RAS prior to PTRA. Captopril renography with {sup 99m}Tc-MAG 3 has a high sensitivity (94%) and acceptable specificity (88%) for the screening of hypertensive patients. The positive predictive value is 74% and the negative predictive value 98%, compared with the 'gold standard' of angiography. (orig.).

  13. High Fat Diets Sex-Specifically Affect the Renal Transcriptome and Program Obesity, Kidney Injury, and Hypertension in the Offspring.

    Science.gov (United States)

    Tain, You-Lin; Lin, Yu-Ju; Sheen, Jiunn-Ming; Yu, Hong-Ren; Tiao, Mao-Meng; Chen, Chih-Cheng; Tsai, Ching-Chou; Huang, Li-Tung; Hsu, Chien-Ning

    2017-04-03

    Obesity and related disorders have increased concurrently with an increased consumption of saturated fatty acids. We examined whether post-weaning high fat (HF) diet would exacerbate offspring vulnerability to maternal HF-induced programmed hypertension and kidney disease sex-specifically, with a focus on the kidney. Next, we aimed to elucidate the gene-diet interactions that contribute to maternal HF-induced renal programming using the next generation RNA sequencing (NGS) technology. Female Sprague-Dawley rats received either a normal diet (ND) or HF diet (D12331, Research Diets) for five weeks before the delivery. The offspring of both sexes were put on either the ND or HF diet from weaning to six months of age, resulting in four groups of each sex (maternal diet/post-weaning diet; n = 5-7/group): ND/ND, ND/HF, HF/ND, and HF/HF. Post-weaning HF diet increased bodyweights of both ND/HF and HF/HF animals from three to six months only in males. Post-weaning HF diet increased systolic blood pressure in male and female offspring, irrespective of whether they were exposed to maternal HF or not. Male HF/HF offspring showed greater degrees of glomerular and tubular injury compared to the ND/ND group. Our NGS data showed that maternal HF diet significantly altered renal transcriptome with female offspring being more HF-sensitive. HF diet induced hypertension and renal injury are associated with oxidative stress, activation of renin-angiotensin system, and dysregulated sodium transporters and circadian clock. Post-weaning HF diet sex-specifically exacerbates the development of obesity, kidney injury, but not hypertension programmed by maternal HF intake. Better understanding of the sex-dependent mechanisms that underlie HF-induced renal programming will help develop a novel personalized dietary intervention to prevent obesity and related disorders.

  14. [Cardiometabolic and cardiorenal syndromes interactions in Algerian diabetic-hypertensive patient: interest of predictive multi-biomarkers strategy to renal dysfunction].

    Science.gov (United States)

    Zoubiri, Houda; Kacimi, Ghouti; Haffaf, El Mahdi; Oudjit, Brahim; Adjroud, Naima; Koceir, Elhadj-Ahmed

    2015-01-01

    The coexistence of essential hypertension (EH) in type 2 diabetic (T2D) patients greatly enhances chronic kidney disease. To assess the acute renal dysfunction in two cohorts of diabetic-hypertensive subjects. The inaugural pathology for each group is either T2D or EH. The study was undertaken on 506 subjects who were divided in 5 groups according to age and sex: diabetic, hypertensive, diabetic- hypertensive (DH and HD) and healthy groups. Patients were phenotyped regarding their cardiometabolic syndrome (CMS) profile using the NCEP/ATPIII criteria and cardiorenal syndrome (CRS) according to the International kidney foundation. Hypertension was defined as systolic (SBP) and diastolic (DBP) blood pressure ≥ 140/90 mmHg, respectively. Insulin resistance (IR) was assessed by Homa-IR model. Glomerular filtration rate (GFR) by creatinine clearance. CMS and CRS parameters were determined on Cobas®. The SBP and DBP measurements by electronic blood pressure using Omron 705 CP® type. IR was found in all diabetics and hypertensive patients. Dyslipidemia are correlated to % body fat mass accretion in all groups. In DH group, the renal disorder is confirmed by decreased GFR (30%) and increased microalbuminuria (> 30 mg/24h); associated with increased NT-pro BNP and plasma aldosterone depletion. Several biomarkers are necessary to detection kidney disease and renal failure prevention in diabetic patients to hypertensive state. The renal dysfunction was significantly related to T2D-EH disease.

  15. Maintenance of Hypertensive Hemodynamics Does Not Depend on ROS in Established Experimental Chronic Kidney Disease

    Science.gov (United States)

    Papazova, Diana A.; van Koppen, Arianne; Koeners, Maarten P.; Bleys, Ronald L.; Verhaar, Marianne C.; Joles, Jaap A.

    2014-01-01

    While the presence of oxidative stress in chronic kidney disease (CKD) is well established, its relation to hypertensive renal hemodynamics remains unclear. We hypothesized that once CKD is established blood pressure and renal vascular resistance (RVR) no longer depend on reactive oxygen species. CKD was induced by bilateral ablation of 2/3 of each kidney. Compared to age-matched, sham-operated controls all ablated rats showed proteinuria, decreased glomerular filtration rate (GFR), more renal damage, higher mean arterial pressure (MAP), RVR and excretion of oxidative stress markers and hydrogen peroxide, while excretion of stable nitric oxide (NO) metabolites tended to decrease. We compared MAP, RVR, GFR and fractional excretion of sodium under baseline and during acute Tempol, PEG-catalase or vehicle infusion in rats with established CKD vs. controls. Tempol caused marked reduction in MAP in controls (96±5 vs.79±4 mmHg, PTempol and PEG-catalase slightly decreased RVR in both groups. Fractional excretion of sodium was increased by both Tempol and PEG-catalase in both groups. PEG-catalase decreased TBARS excretion in both groups. In sum, although oxidative stress markers were increased, MAP and RVR did not depend more on oxidative stress in CKD than in controls. Therefore reactive oxygen species appear not to be important direct determinants of hypertensive renal hemodynamics in this model of established CKD. PMID:24533120

  16. Effect of tempol and tempol plus catalase on intra-renal haemodynamics in spontaneously hypertensive stroke-prone (SHSP) and Wistar rats.

    Science.gov (United States)

    Ahmeda, Ahmad F; Rae, Mark G; Al Otaibi, Mohammed F; Anweigi, Lamyia M; Johns, Edward J

    2017-05-01

    Vasoconstriction within the renal medulla contributes to the development of hypertension. This study investigated the role of reactive oxygen species (ROS) in regulating renal medullary and cortical blood perfusion (MBP and CBP respectively) in both stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar rats. CBP and MBP were measured using a laser-Doppler flow meter before and after intra-renal infusion of tempol, the superoxide dismutase (SOD) mimetic or tempol plus catalase, the hydrogen peroxide-degrading enzyme. Tempol infusion significantly elevated blood perfusion within the renal medulla (MBP) in both SHRSP (by 43 ± 7%, P catalase and tempol were co-infused, MBP was again significantly increased in SHRSP (by 57 ± 6%, P < 0.001) and Wistar rats (by 33 ± 6%, P < 0.001), with a significantly greater increase in perfusion being induced in the SHRSP relative to the Wistar rats (P < 0.01). Notably, this increase was significantly greater than in those animals infused with tempol alone (P < 0.01). These results suggest that ROS plays a proportionally greater role in reducing renal vascular compliance, particularly within the renal medulla, in normotensive and hypertensive animals, with effects being greater in the hypertensive animals. This supports the hypothesis that SHRSP renal vasculature might be subjected to elevated level of oxidative stress relative to normotensive animals.

  17. Renal denervation in patients with resistant hypertension: six-month results.

    Science.gov (United States)

    Dores, Hélder; de Sousa Almeida, Manuel; de Araújo Gonçalves, Pedro; Branco, Patrícia; Gaspar, Augusta; Sousa, Henrique; Canha Gomes, Angela; Andrade, Maria João; Carvalho, Maria Salomé; Campante Teles, Rui; Raposo, Luís; Mesquita Gabriel, Henrique; Pereira Machado, Francisco; Mendes, Miguel

    2014-04-01

    Increased activation of the sympathetic nervous system plays a central role in the pathophysiology of hypertension (HTN). Catheter-based renal denervation (RDN) was recently developed for the treatment of resistant HTN. To assess the safety and efficacy of RDN for blood pressure (BP) reduction at six months in patients with resistant HTN. In this prospective registry of patients with essential resistant HTN who underwent RDN between July 2011 and May 2013, the efficacy of RDN was defined as ≥ 10 mm Hg reduction in office systolic blood pressure (SBP) six months after the intervention. In a resistant HTN outpatient clinic, 177 consecutive patients were evaluated, of whom 34 underwent RDN (age 62.7 ± 7.6 years; 50.0% male). There were no vascular complications, either at the access site or in the renal arteries. Of the 22 patients with complete six-month follow-up, the response rate was 81.8% (n=18). The mean office SBP reduction was 22 mm Hg (174 ± 23 vs. 152 ± 22 mm Hg; p<0.001) and 9 mm Hg in diastolic BP (89 ± 16 vs. 80 ± 11 mm Hg; p=0.006). The number of antihypertensive drugs (5.5 ± 1.0 vs. 4.6 ± 1.1; p=0.010) and pharmacological classes (5.4 ± 0.7 vs. 4.6 ± 1.1; p=0.009) also decreased significantly. Of the 24-hour ambulatory BP monitoring and echocardiographic parameters analyzed, there were significant reductions in diastolic load (45 ± 29 vs. 27 ± 26%; p=0.049) and in left ventricular mass index (174 ± 56 vs. 158 ± 60 g/m(2); p=0.014). In this cohort of patients with resistant HTN, RDN was safe and effective, with a significant BP reduction at six-month follow-up. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  18. Non invasive assessment of renal artery using dual MRA techniques compared with invasive renal angiography in cases of renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Y. Ragab

    2011-03-01

    Conclusion: The combined approach of non-invasive CE MRA and PC MRA techniques achieves a very high specificity, PPV and NPV for the detection of renal arterial pathomorphologic features as compared to standard renal angiography. Adding PC MRA to CE MRA helps to differentiate between mild and moderate stenoses as well as moderate and sever arterial stenotic lesions. So, CE MRA is a morphological test while PC MRA helps in grading the arterial stenoses.

  19. Hydrogen sulphide and tempol treatments improve the blood pressure and renal excretory responses in spontaneously hypertensive rats.

    Science.gov (United States)

    Ahmad, Fiaz Ud Din; Sattar, Munavvar A; Rathore, Hassaan A; Tan, Yong Chia; Akhtar, Safia; Jin, Oh Hui; Pei, Yen Pei; Abdullah, Nor A; Johns, Edward J

    2014-05-01

    Oxidative stress and suppressed H2S production lead to increased renal vascular resistance, disturbed glomerular hemodynamics, and abnormal renal sodium and water handling, contribute to the pathogenesis and maintenance of essential hypertension in man and the spontaneously hypertensive rat. This study investigated the impact of H2S and tempol alone and in combination on blood pressure and renal hemodynamics and excretory functions in the SHR. Groups of WKY rats or SHR (n=6) were treated for 4 weeks either as controls or received NaHS (SHR+NaHS), tempol (SHR+Tempol), or NaHS plus tempol (SHR+NaHS +Tempol). Metabolic studies were performed on days 0, 14, and 28, thereafter animals were anaesthetized to measure renal hemodynamics and plasma oxidative and antioxidant markers. SHR control rats had higher mean arterial blood pressure (140.0 ± 2 vs. 100.0 ± 3 mmHg), lower plasma and urinary H2S, creatinine clearance, urine flow rate and urinary sodium excretion, and oxidative stress compared to WKY (all ptempol alone decreased blood pressure and oxidative stress and improved renal hemodynamic and excretory function compared to untreated SHR. Combined NaHS and tempol therapy in SHRs caused larger decreases in blood pressure (∼20-22% vs. ∼11-15% and ∼10-14%), increases in creatinine clearance, urinary sodium excretion and fractional sodium excretion and up-regulated the antioxidant status compared to each agent alone (all ptempol together resulted in greater reductions in blood pressure and normalization of kidney function compared with either compound alone.

  20. [Jinshuibao capsule combined losartan potassium intervened early renal damage of hypertension patients of yin and yang deficiency: a clinical research].

    Science.gov (United States)

    Zhang, Cheng-Qiu; Yin, Ji-Qing; Xin, Qing; Wang, Ya-Qin; Ge, Zhi-Ming

    2013-06-01

    To observe the effects of Jinshuibao Capsule (JC) combined losartan potassium on some indices of early renal damage of hypertension patients of yin and yang deficiency syndrome (YYDS), such as levels of serum cystatin C (Cys C), beta2-microglobulin (beta2-MG), hypersensitive C-reactive protein (hs-CRP), uric acid (UA), blood pressure, blood lipids, and fasting blood glucose (FBG), and to explore their protective effects on early renal damage of hypertension patients and on the metabolisms of blood lipids and blood glucose. Totally 106 hypertension patients of YYDS were randomly assigned to two groups, 53 patients in the control group (treated by losartan potassium) and 53 patients in the treatment group (treated by JC + losartan potassium). The treatment lasted for 16 weeks. The serum changes of UA, Cys C, beta2-MG, hs-CRP, blood lipids [including total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C)], and FBG levels were measured to evaluate the renal protective effects and to assess their effect on the metabolisms of blood lipids and blood glucose. Compared with before treatment in the same group, the systolic blood pressure (SBP) decreased in the two groups after treatment, showing statistical difference (P 0.05). The diastolic blood pressure (DBP) was not obviously declined in the two groups after treatment, showing no statistical difference. Compared with before treatment in the same group, the LDL-C level decreased obviously after treatment in the control group. But there was no obvious change in FBG, TC, HDL-C, and TG in the control group, showing no statistical difference when compared with before treatment (P 0.05). Compared with before treatment in the same group, the levels of UA, Cys C, beta2-MG, and hs-CRP all decreased in the two groups, showing statistical difference (P < 0.05, P < 0.01). The SCr level decreased in the treatment group more obviously after treatment

  1. Endothelial Dysfunction in Experimental Models of Arterial Hypertension: Cause or Consequence?

    Directory of Open Access Journals (Sweden)

    Iveta Bernatova

    2014-01-01

    Full Text Available Hypertension is a risk factor for other cardiovascular diseases and endothelial dysfunction was found in humans as well as in various commonly employed animal experimental models of arterial hypertension. Data from the literature indicate that, in general, endothelial dysfunction would not be the cause of experimental hypertension and may rather be secondary, that is, resulting from high blood pressure (BP. The initial mechanism of endothelial dysfunction itself may be associated with a lack of endothelium-derived relaxing factors (mainly nitric oxide and/or accentuation of various endothelium-derived constricting factors. The involvement and role of endothelium-derived factors in the development of endothelial dysfunction in individual experimental models of hypertension may vary, depending on the triggering stimulus, strain, age, and vascular bed investigated. This brief review was focused on the participation of endothelial dysfunction, individual endothelium-derived factors, and their mechanisms of action in the development of high BP in the most frequently used rodent experimental models of arterial hypertension, including nitric oxide deficient models, spontaneous (prehypertension, stress-induced hypertension, and selected pharmacological and diet-induced models.

  2. Hypertension in paediatrics: Can pre- and post-captopril technetium-99m dimercaptosuccinic acid renal scans exclude renovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Minty, I. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology); Lythgoe, M.F. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology); Gordon, I. (Hospital for Sick Children, London (United Kingdom). Dept. of Radiology)

    1993-08-01

    In children over 1 year of age, renal disease is the commonest cause of hypertension. Arteriography is considered the reference method to establish the diagnosis of enovascular disease; however, it is an invasive technique with a high radiation burden for children. This was a retrospective study of pre- and post-capto-technetium-99m dimercaptosuccinic acid (DMSA) imaging compared with arteriography in 18 children between the ages of 3 and 17 years. Alone, the [sup 99m]Tc-DMSA scan is a sensitive indicator of renal parenchymal disease, although non-specific in suggesting the pathology. The combination of pre- and post-captopril studies may increase the sensitivity and specificity in the diagnosis of renovascular disease in the presence of hypertension. This work suggests that a screening investigation with a low radiation burden can be carried out at most institutions; if the investigation is positive, there will be a high index of suspicion that renovascular disease is the cause of the hypertension. (orig.)

  3. The Renal Protective Effect of Jiangya Tongluo Formula, through Regulation of Adrenomedullin and Angiotensin II, in Rats with Hypertensive Nephrosclerosis

    Directory of Open Access Journals (Sweden)

    Lin Han

    2015-01-01

    Full Text Available We investigated the effect of Jiangya Tongluo (JYTL formula on renal function in rats with hypertensive nephrosclerosis. A total of 21 spontaneously hypertensive rats (SHRs were randomized into 3 groups: valsartan (10 mg/kg/d valsartan, JYTL (14.2 g/kg/d JYTL, and a model group (5 mL/kg/d distilled water; Wistar Kyoto rats comprised the control group (n = 7, 5 mL/kg/d distilled water. Treatments were administered by gavage every day for 8 weeks. Blood pressure, 24-h urine protein, pathological changes in the kidney, serum creatinine, and blood urea nitrogen (BUN levels were estimated. The contents of adrenomedullin (ADM and angiotensin II (Ang II in both the kidney and plasma were evaluated. JYTL lowered BP, 24-h urine protein, serum creatinine, and BUN. ADM content in kidneys increased and negatively correlated with BP, while Ang II decreased and negatively correlated with ADM, but there was no statistically significant difference of plasma ADM between the model and the treatment groups. Possibly, activated intrarenal renin-angiotensin system (RAS plays an important role in hypertensive nephrosclerosis and the protective function of ADM via local paracrine. JYTL may upregulate endogenous ADM level in the kidneys and antagonize Ang II during vascular injury by dilating renal blood vessels.

  4. Vasodysfunction That Involves Renal Vasodysfunction, Not Abnormally Increased Renal Retention of Sodium, Accounts for the Initiation of Salt-Induced Hypertension

    Science.gov (United States)

    Morris, R. Curtis; Schmidlin, Olga; Sebastian, Anthony; Tanaka, Masae; Kurtz, Theodore W.

    2016-01-01

    Prevailing theory holds that abnormally large increases in renal salt retention and cardiac output are early pathophysiologic events mediating initiation of most instances of salt-induced hypertension. This theory has come under increasing scrutiny because it is based on studies that lack measurements of sodium balance and cardiac output obtained during initiation of salt-loading in proper normal controls, i.e., salt-resistant subjects with normal blood pressure. Here we make the case for a “vasodysfunction” theory for initiation of salt-induced hypertension: In response to an increase in salt intake, a subnormal decrease in total peripheral resistance that involves a subnormal decrease in renal vascular resistance, in the absence of abnormally large increases in sodium retention and cardiac output, is the hemodynamic abnormality that usually mediates initiation of salt-induced increases in blood pressure (BP). It is the failure to normally decrease vascular resistance in response to salt loading that enables a normal increase of cardiac output to initiate the salt-induced increase in blood pressure. This theory is based on the results of properly controlled studies which consistently demonstrate that in salt-sensitive subjects, salt-loading initiates increased BP through a hemodynamic mechanism that: 1) does not usually involve early increases in sodium retention and cardiac output greater than those which occur with salt-loading in normal controls, and 2) usually involves an early failure to decrease vascular resistance to the same extent as that observed during salt-loading in normal controls. Multiple mechanisms including disturbances in nitric oxide and sympathetic nervous system activity likely underlie this subnormal vasodilatory response to salt that usually precedes and initiates salt-induced hypertension. PMID:26927006

  5. RENAL HEMODYNAMICS AND GLOMERULAR FILTRATION RATE IN MEN AND WOMEN WITH ARTERIAL HYPERTENSION AT THE AGE OF 40-60 YEARS

    Directory of Open Access Journals (Sweden)

    I. G. Fomina

    2015-12-01

    Full Text Available Aim. To study parameters of a renal hemodynamic and the general glomerular filtration rate (GGFR and their correlations with cardiovascular risk factors (RF in patient with arterial hypertension (AH.Material and methods. 102 patients with AH (35 men and 67 women of 40-60 y.o. were involved in the study. 20 persons (10 men and 10 women with normal blood pressure (BP were included in control group. Dynamic renal angioscintigraphy was used for an estimation of a renal hemodynamic and GGFR.Results. Hypertensive women had lower renal blood flow and GGFR than these in men (p<0,000. Renal hemodynamics and GGFR in men and women did not differ in control group. Positive correlation  r=0,61; p<0,05 between GGFR and a tobacco smoking was found in hypertensive men as well as negative correlation (r=-0,41; p<0,005 between GGFR and body mass index (BMI in women.Conclusion. Renal blood flow and GGFR are lower in hypertensive women than these in men. Positive correlation between GGFR and tobacco smoking and negative correlation between GGFR and BMI were found in men and women respectively.

  6. Precision Medicine for Hypertension Management in Chronic Kidney Disease: Relevance of SPRINT for Therapeutic Targets in Nondiabetic Renal Disease.

    Science.gov (United States)

    Ruzicka, Marcel; Burns, Kevin D; Hiremath, Swapnil

    2017-05-01

    In this review we evaluate the literature to determine if lower blood pressure (BP) targets are beneficial for patients with nondiabetic chronic kidney disease (CKD). Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), and Ramipril Efficacy in Nephropathy-2 (REIN-2), designed to assess the benefit of lower BP on progression of nondiabetic CKD, generally came to the same negative conclusion. They were not designed and powered to assess an effect of lower BP on cardiovascular outcomes. The Systolic Blood Pressure Intervention Trial (SPRINT) was the first trial designed and powered to address this issue, and showed a clear benefit of a lower targeted and achieved BP. SPRINT did not show any renal benefits from lower BP, and it was not designed to assess this outcome, and it enrolled patients with less "renal risk" per se. A distinguishing feature of SPRINT compared with other large trials is that it highlighted the importance of precise BP measurement methods in defining targets in hypertension treatment. Accordingly, we propose that SPRINT is truly a "game-changing" clinical trial that sets the bar for management of hypertension in select patients with nondiabetic CKD. In these patients, systolic BP target depends critically on the BP measurement method: < 140 mm Hg when derived from 3 readings using a mercury sphygmomanometer after 5 minutes of rest, < 130 mm Hg when calculated from at a minimum of 3 readings using an automated oscillometric device, and < 120 mm Hg when taken using an automated oscillometric device after 5 minutes of unattended rest. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  7. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  8. The protective effect of a buckwheat-enriched diet on renal injury in high salt-induced hypertension in rats.

    Science.gov (United States)

    Cheng, Dai; Zhang, Xinyu; Meng, Meng; Han, Lirong; Li, Zheng; Hou, Lihua; Qi, Wentao; Wang, Chunling

    2016-08-10

    An excess of dietary salt is the most common factor that contributes to the pathogenesis of hypertension. Dietary management is deemed critical to prevent and treat hypertension. We aimed at evaluating the preventive effect of the buckwheat (BW)-enriched diet on high salt-induced elevation of blood pressure (BP) and renal injury in order to provide a new focus on the design of strategies to prevent hypertension. Control, high salt (HS)-treated (8%), HS + tartary buckwheat (TB) (8% HS + 15% TB), and a group of HS + common buckwheat (CB) (8% HS + 15% CB) rats were used for 7 weeks. BP was monitored periodically during the study by the tail cuff method. HS intake caused a significant increase of BP, the level of serum Na(+) compared to the control group. BW significantly prevented the increase of BP, attenuated oxidative damage, and improved Na(+)/K(+)-ATPase activity in HS treated rats. These results show that a diet supplemented with whole BW has beneficial effects on hypertension, by decreasing blood pressure values and oxidative stress.

  9. High performance of a risk calculator that includes renal function in predicting mortality of hypertensive patients in clinical application.

    Science.gov (United States)

    Ravera, Maura; Cannavò, Rossella; Noberasco, Giuseppe; Guasconi, Alessandro; Cabib, Ursula; Pieracci, Laura; Pegoraro, Valeria; Brignoli, Ovidio; Cricelli, Claudio; Deferrari, Giacomo; Paoletti, Ernesto

    2014-06-01

    The aim of this study was to assess the accuracy of a risk calculator that includes renal function as compared with that of the traditional Framingham Risk Score (FRS) in predicting the risk of mortality of hypertensive individuals managed in primary care. From the databases of British and Italian General Practitioners, we retrieved demographic and clinical data for 35 101 UK and 27 818 Italian individuals aged 35-74 years with a diagnosis of hypertension. Then, the 5-year incidence of cardiovascular events as well as all-cause and cardiovascular mortality were recorded for both samples. A comparison analysis of the performance of the Individual Data Analysis of Antihypertensive Intervention Trials (INDANA) calculator with that of FRS in predicting 5-year all-cause and cardiovascular mortality risk was made. The INDANA calculator was more accurate than the FRS in predicting all-cause [Δc 0.038, 95% confidence interval (CI) 0.026-0.051 for United Kingdom, and 0.018, 95% CI 0.010-0.027 for Italy, both P calculator, 20% of the UK and 10% of the Italian patients were reclassified to higher risk classes for all-cause mortality, and 25 and 28%, respectively were reclassified when cardiovascular mortality was assessed (P calculator proved to be more accurate than the FRS in predicting the risk of mortality in hypertensive patients and should be considered for systematic adoption for risk stratification of hypertensive individuals managed in primary care.

  10. bENaC is a molecular component of a VSMC mechanotransducer that contributes to renal blood flow regulation, protection from renal injury and hypertension.

    Directory of Open Access Journals (Sweden)

    Heather Anne Drummond

    2012-08-01

    Full Text Available Pressure-induced constriction (also known as the myogenic response is an important mechanodependent response in certain blood vessels. The response is mediated by vascular smooth muscle cells (VSMCs and characterized by a pressure-induced vasoconstriction in small arteries and arterioles in the cerebral, mesenteric, cardiac and renal beds. The myogenic response has two important roles; it is a mechanism of blood flow autoregulation and provides protection against systemic blood pressure-induced damage to delicate microvessels. However, the molecular mechanism(s underlying initiation of myogenic response is unclear. Degenerin proteins have a strong evolutionary link to mechanotransduction in the nematode. Our laboratory has addressed the hypothesis that these proteins may also act as mechanosensors in certain mammalian tissues such as VSMCs and arterial baroreceptor neurons. This article discusses the importance of a specific degenerin protein, β Epithelial Na+ Channel (βENaC in pressure-induced vasoconstriction in renal vessels and arterial baroreflex function as determined in a mouse model of reduced βENaC (βENaC m/m. We propose that loss of baroreflex sensitivity (due to loss of baroreceptor βENaC increases blood pressure variability, increasing the likelihood and magnitude of upward swings in systemic pressure. Furthermore, loss of the myogenic constrictor response (due to loss of VSMC βENaC will permit those pressure swings to be transmitted to the microvasculature in βENaC m/m mice, thus increasing the susceptibility to renal injury and hypertension.

  11. Progression of Renal Insufficiency in Patients with Essential Hypertension Treated with Renin Angiotensin Aldosterone System Blockers: An Electrocardiographic Correlation

    Directory of Open Access Journals (Sweden)

    Luis Rodriguez-Padial

    2017-12-01

    Full Text Available Background: There is a frequent association between renal insufficiency and cardiovascular disease in patients with essential hypertension (HTN. The aim of this study was to analyze the relationship between ECG parameters and the progress of renal damage in patients with treated HTN. Methods: 109 patients with HTN had their microalbuminuria monitored over a 3-year time frame. During the last 3 months of follow-up, an ECG was recorded. Patients were divided into 3 groups according to the deterioration of their renal function: normoalbuminuria during the study period (normo–normo; n = 51; normoalbuminuria developing microalbuminuria (normo–micro; n = 29; and microalbuminuria at baseline (micro–micro; n = 29. Results: There were no differences in presence of left ventricular hypertrophy between the 3 groups. RV6/RV5 >1 was observed more frequently as renal function declined (p = 0.025. The 12-lead QRS-complex voltage-duration product was significantly increased in patients without microalbuminuria at baseline who went on to develop microalbuminuria (p = 0.006. Patients who developed microalbuminuria during follow-up, with positive Cornell voltage criteria, showed a lesser degree of progression of microalbuminuria when compared with the rest of the subgroups (p = 0.044. Furthermore, patients with microalbuminuria at baseline treated with angiotensin receptor blockers and diuretics, and positive Cornell voltage criteria, showed a higher degree of microalbuminuria compared to those with negative Cornell voltage criteria (p = 0.016. Conclusions: In patients with HTN, we identified some ECG parameters, which predict renal disease progression in patients with HTN, which may permit the identification of patients who are at risk of renal disease progression, despite optimal antihypertensive pharmacotherapy.

  12. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil...

  13. Management of Renal Artery Stenosis - an Update | Alhadad ...

    African Journals Online (AJOL)

    The role of the renal vasculature in eliciting renovascular hypertension (RVH) was established in 1934, when Goldblatt et al. [1] in a classical experimental study demonstrated that partial obstruction of the renal artery increased mean arterial blood pressure (BP). The pathophysiology of renal artery stenosis (RAS) is ...

  14. Endothelin-A receptor blockade slows the progression of renal injury in experimental renovascular disease.

    Science.gov (United States)

    Kelsen, Silvia; Hall, John E; Chade, Alejandro R

    2011-07-01

    Endothelin (ET)-1, a potent renal vasoconstrictor with mitogenic properties, is upregulated by ischemia and has been shown to induce renal injury via the ET-A receptor. The potential role of ET-A blockade in chronic renovascular disease (RVD) has not, to our knowledge, been previously reported. We hypothesized that chronic ET-A receptor blockade would preserve renal hemodynamics and slow the progression of injury of the stenotic kidney in experimental RVD. Renal artery stenosis, a major cause of chronic RVD, was induced in 14 pigs and observed for 6 wk. In half of the pigs, chronic ET-A blockade was initiated (RVD+ET-A, 0.75 mg·kg(-1)·day(-1)) at the onset of RVD. Single-kidney renal blood flow, glomerular filtration rate, and perfusion were quantified in vivo after 6 wk using multidetector computer tomography. Renal microvascular density was quantified ex vivo using three-dimensional microcomputer tomography, and growth factors, inflammation, apoptosis, and fibrosis were determined in renal tissue. The degree of stenosis and increase in blood pressure were similar in RVD and RVD+ET-A pigs. Renal hemodynamics, function, and microvascular density were decreased in the stenotic kidney but preserved by ET-A blockade, accompanied by increased renal expression of vascular endothelial growth factor, hepatocyte growth factor, and downstream mediators such as phosphorilated-Akt, angiopoietins, and endothelial nitric oxide synthase. ET-A blockade also reduced renal apoptosis, inflammation, and glomerulosclerosis. This study shows that ET-A blockade slows the progression of renal injury in experimental RVD and preserves renal hemodynamics, function, and microvascular density in the stenotic kidney. These results support a role for ET-1/ET-A as a potential therapeutic target in chronic RVD.

  15. [Neurophysiologic mechanisms of arterial hypertension under experimental chronic emotional stress].

    Science.gov (United States)

    Baumann, H; Martin, G; Urmantscheeva, T G; Degen, G; Wolter, F; Chasabova, W A; Gurk, C; Hinays, I; Läuter, J

    1976-01-01

    Neurophysiological studies were conducted with subhuman primates (macaca mulatta) in order to obtain an estimate of central nervous effects of socio-emotional stress. This was combined with continuously aggravated conditioning procedures in view of the possible significance of chronic environmental stress escalation for etiology and pathogenesis of an arterial hypertension model. Our conclusions are based on evoked potentials (EP) as integrative characteristics of cerebral information processing. The EPs were recorded by means of electrodes chronically implanted in brain structures of emotional and cardio-vascular relevance. Multivariate mathematico-statistical analyses of average EPs (AEP) provide an objective measure of stress sensibility of the individual, particularly of the effects of acute and chronic environmental stress factors upon the functional organization of the CNS. By means of a quantitative approach to AEP we were able to demonstrate a disjunction between distinct limbic and hypothalamic structures starting under stress conditions of subchronic character. We assume that the constancy of functionally antagonistic hyperactive excitation foci at diencephalic and supradiencephalic levels and their specific interaction with the equally stress related neocortical functional insufficiency constitutes a decisive pathogenetic central mechanism of neurotic behaviour. Long-term changes of amplification of external and internal afferences could be demonstrated on the basis of hypo- and hyperreactive neuroelectric functional patterns. These processes cause cerebro-visceral regulatory diseases as, e. g., a primary arterial hypertension by restriction of neocortical control and the corresponding efferent reactions for re-establishment of the dynamic homeostasis.

  16. Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    International Nuclear Information System (INIS)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit

    2010-01-01

    Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ( 51 Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51 Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ( 51 Cr-EDTA) and 99m Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m 2 in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m 2 in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m 2 , p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m 2 , p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show

  17. Glomerular filtration rate measured by {sup 51}Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit, E-mail: annaalice100@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2010-07-01

    Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using {sup 51}Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ({sup 51}Cr-EDTA) and {sup 99m}Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6+-21.8 ml/kg/1.73 m{sup 2} in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1+-28.7 ml/kg/1.73m{sup 2} in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+-14.8 ml/kg/1.73m{sup 2}, p=0.001) and an insignificant change in the group without RAS (to 62.2+-23.6 ml/kg/1.73m{sup 2}, p=0.68). Scintigraphy with technetium-99m dimercapto

  18. Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

    Science.gov (United States)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit

    2010-01-01

    INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis (51Cr-EDTA) and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m2 in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m2 in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/ kg/1.73m2, p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m2, p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show significant

  19. Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Anna Alice Rolim Chaves

    2010-01-01

    Full Text Available INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21 and without renal artery stenosis, (n=20. In vitro glomerular filtration rate analysis (51Cr-EDTA and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m² in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m² in the group without renal artery stenosis (p=0.04. Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m², p=0.001 and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m², p=0.68. Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA did not show

  20. Study on the Renal Anemia: Experimental Study in Acute Renal Anemia

    International Nuclear Information System (INIS)

    Yoon, Zo Eun

    1969-01-01

    The double tracer study on erythrokinetics was carried out experimentally with radioactive iron( 59 Fe) and chromium ( 51 Cr) in rabbits. The 0.1% cantharidin solution and 1% pot. perchlomate solution was given subcutaneously to 20 rabbits respectively. 3 and 6 days after injection, the blood chemistry, urine examination, ferrokinetics and apparent half survival time of RBC were ( 51 Cr T-1/2) determined. Following were the results: 1) Red blood cell hematocrit and hemoglobin values were moderately reduced and B.U.N. and serum creatinine values were slightly increased in the cantharidin group, while B.U.N. and serum creatinine values were within normal limits in the pot. perchlomate group. Reticulocyte values were slightly increased in the cantharidin group, while was normal range in the pot. perchlomate group. 2) Blood chemistry finding was not significant statistically in both experimental groups, but serum iron value was moderately reduced in both group. 3) Plasma volume was unchanged in both group, but red cell volume and whole blood volume were slightly reduced in both groups. 4) Results of ferrokinetics were as follows: i) The plasma iron disappearance rate was delayed in both groups. Plasma iron turnover rate, red cell iron utilization and red cell iron turnover rate were decreased in both groups, and then red cell iron turnover rate was more decreased than plasma iron turnover rate in both groups. Circulating red cell iron was slightly increased in cantharidin group and red cell iron concentration was within normal range in both groups. ii) P.I.T.R.-R.C.I.T. value moderately increased in the cantharidin group and slightly increased in the pot. perchlomate group. Reticulocyte index, red cell iron turnover index, plasma iron turnover index and effective erythropoiesis index were wholly reduced in both groups. iii) The red cell life span was slightly shortened in the cantharidin group while was within normal range in pot. perchlomate group. The pathologic

  1. The Effect of Renal Denervation on Plasma Adipokine Profile in Patients with Treatment Resistant Hypertension

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    Nina Eikelis

    2017-05-01

    Full Text Available Background: We previously demonstrated the effectiveness of renal denervation (RDN to lower blood pressure (BP at least partially via the reduction of sympathetic stimulation to the kidney. A number of adipocyte-derived factors are implicated in BP control in obesity.Aim: The aim of this study was to examine whether RDN may have salutary effects on the adipokine profile in patients with resistant hypertension (RH.Methods: Fifty seven patients with RH undergoing RDN program have been included in this study (65% males, age 60.8 ± 1.5 years, BMI 32.6 ± 0.7 kg/m2, mean ± SEM. Throughout the study, the patients were on an average of 4.5 ± 2.7 antihypertensive drugs. Automated seated office BP measurements and plasma concentrations of leptin, insulin, non-esterified fatty acids (NEFA, adiponectin and resistin were assessed at baseline and the 3 months after RDN.Results: There was a significant reduction in mean office systolic (168.75 ± 2.57 vs. 155.23 ± 3.17 mmHg, p < 0.001 and diastolic (90.68 ± 2.31 vs. 83.74 ± 2.36 mmHg, p < 0.001 BP 3 months after RDN. Body weight, plasma leptin and resistin levels and heart rate remained unchanged. Fasting insulin concentration significantly increased 3 months after the procedure (20.05 ± 1.46 vs. 29.70 ± 2.51 uU/ml, p = 0.002. There was a significant drop in circulating NEFA at follow up (1.01 ± 0.07 vs. 0.47 ± 0.04 mEq/l, p < 0.001. Adiponectin concentration was significantly higher after RDN (5,654 ± 800 vs. 6,644 ± 967 ng/ml, p = 0.024.Conclusions: This is the first study to demonstrate that RDN is associated with potentially beneficial effects on aspects of the adipokine profile. Increased adiponectin and reduced NEFA production may contribute to BP reduction via an effect on metabolic pathways.Clinical Trial Registration Number: NCT00483808, NCT00888433.

  2. Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients.

    Science.gov (United States)

    Osté, Maryse C J; Gomes-Neto, António W; Corpeleijn, Eva; Gans, Rijk O B; de Borst, Martin H; van den Berg, Else; Soedamah-Muthu, Sabita S; Kromhout, Daan; Navis, Gerjan J; Bakker, Stephan J L

    2018-02-21

    Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as an important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective cohort study of adult RTR. Dietary data were collected using a validated 177-item food frequency questionnaire and an overall DASH-score was obtained. We included 632 stable RTR (mean ± standard deviation age 53.0 ± 12.7 years, 57% men). Mean DASH score was 23.8 ± 4.7. During median follow-up of 5.3 (interquartile range, 4.1-6.0) years, 119 (18.8%) RTR had renal function decline, defined as a combined endpoint of doubling of serum creatinine and death-censored graft failure, and 128 (20.3%) died. In Cox-regression analyses, RTR in the highest tertile of the DASH score had lower risk of both renal function decline (hazard ratio [HR] = 0.57; 95% confidence interval [CI], 0.33-0.96, P = .03) and all-cause mortality (HR = 0.52; 95%CI, 0.32-0.83, P = .006) compared to the lowest tertile, independent of potential confounders. Adherence to a DASH-style diet is associated with lower risk of both renal function decline and all-cause mortality. These results suggest that a healthful diet might benefit long-term outcome in RTR. © 2018 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Cardiac Body Surface Potentials in Rats with Experimental Pulmonary Hypertension during Ventricular Depolarization.

    Science.gov (United States)

    Suslonova, O V; Smirnova, S L; Roshchevskaya, I M

    2016-11-01

    The spatial and the amplitude-temporal parameters of cardiac body surface potentials were examined in female Wistar rats with experimental pulmonary hypertension during ventricular depolarization. The cardiac body surface potentials have been led from 64 subcutaneous electrodes evenly distributed across the chest surface prior to and 4 weeks after subcutaneous injection of a single dose of monocrotaline (60 mg/kg). Right ventricular hypertrophy and electrophysiological remodeling of the heart developed in rats with experimental pulmonary hypertension in 4 weeks after monocrotaline injection; these changes led to a significant increase in amplitude and temporal characteristics of the cardioelectric field on the body surface in comparison with the initial state.

  4. Spice up the hypertension diet - curcumin and piperine prevent remodeling of aorta in experimental L-NAME induced hypertension

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    Janega Pavol

    2011-10-01

    Full Text Available Abstract Background Increase of blood pressure is accompanied by functional and morphological changes in the vascular wall. The presented study explored the effects of curcuma and black pepper compounds on increased blood pressure and remodeling of aorta in the rat model of experimental NO-deficient hypertension. Methods Wistar rats were administered for 6 weeks clear water or L-NAME (40 mg/kg/day dissolved in water, piperine (20 mg/kg/day, curcumin (100 mg/kg/day or their combination in corn oil by oral gavage. The systolic blood pressure was measured weekly. Histological slices of thoracic aorta were stained with hematoxylin and eosin, Mallory's phosphotungstic acid hematoxylin (PTAH, orcein, picrosirius red and van Gieson staining and with antibodies against smooth muscle cells actin. Microscopic pictures were digitally processed and morphometrically evaluated. Results The increase of blood pressure caused by L-NAME was partially prevented by piperine and curcumin, but the effect of their combination was less significant. Animals with hypertension had increased wall thickness and cross-sectional area of the aorta, accompanied by relative increase of PTAH positive myofibrils and decrease of elastin, collagen and actin content. Piperine was able to decrease the content of myofibrils and slightly increase actin, while curcumin also prevented elastin decrease. The combination of spices had similar effects on aortic morphology as curcumin itself. Conclusions Administration of piperine or curcumin, less their combination, is able to partially prevent the increase of blood pressure caused by chronic L-NAME administration. The spices modify the remodeling of the wall of the aorta induced by hypertension. Our results show that independent administration of curcumin is more effective in preventing negative changes in blood vessel morphology accompanying hypertensive disease.

  5. Long-term quality of life and clinical outcomes in patients with resistant hypertension treated with renal denervation

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    Agata Krawczyk-Ożóg

    2016-11-01

    Full Text Available Introduction: Pharmacological treatment combined with lifestyle modifications is an effective treatment for arterial hypertension. However, there are still patients who do not respond to standard treatments. Patients with pharmacologically resistant hypertension may benefit from renal denervation (RDN. Aim: To assess long-term quality of life (QoL after RDN and effectiveness in reduction of blood pressure (BP in patients with resistant hypertension. Material and methods: From 2011 to 2014, 12 patients with previously diagnosed resistant hypertension, treated by RDN, were included in this study. The QoL was assessed using a standardized Polish version of the Nottingham Health Profile questionnaire (NHP. Results : The median age was 54 (IQR: 51–57.5 years. Mean baseline ambulatory pre-procedural systolic/diastolic BP was 188/115 ±29.7/18 mm Hg. The mean values of systolic/diastolic BP measured perioperatively and 3, 6, 12 and 24 months postoperatively were 138/86, 138/85, 146/82, 152/86, and 157/91. All p-values for mean systolic and diastolic BP before versus successive time points after RDN were statistically significant; p-value for all comparisons < 0.05. Improvement of QoL was only observed in two sections of the NHP questionnaire: emotional reaction and sleep disturbance. The analysis of the NHP index of Distress (NHP-D showed a lower distress level perioperatively and 3, 6, 12 and 24 months after RDN as compared to baseline. The RDN was not associated with any significant adverse events. Conclusions : Patients with pharmacologically resistant hypertension treated with RDN achieved significant reduction in BP during 24-month follow-up. Furthermore, a significant improvement in the QoL was observed in those patients.

  6. Hypertension.

    Science.gov (United States)

    Winter, Katherine H; Tuttle, Laura A; Viera, Anthony J

    2013-03-01

    Hypertension is the most common modifiable risk factor for cardiovascular disease. Antihypertensive treatment substantially reduces the risk of heart failure, stroke, and myocardial infarction. Current guidelines recommend screening all adults for high blood pressure (BP). Lifestyle modifications to help control high BP include weight loss, exercise, moderation of alcohol intake, and a diet low in sodium and saturated fats and high in fruits and vegetables. Out-of-office BP monitoring should be used to confirm suspected white coat effect, especially in patients with apparent resistant hypertension. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Cuff-Based Oscillometric Central and Brachial Blood Pressures Obtained Through ABPM are Similarly Associated with Renal Organ Damage in Arterial Hypertension.

    Science.gov (United States)

    Fernández-Llama, Patricia; Pareja, Júlia; Yun, Sergi; Vázquez, Susana; Oliveras, Anna; Armario, Pedro; Blanch, Pedro; Calero, Francesca; Sierra, Cristina; de la Sierra, Alejandro

    2017-01-01

    Central blood pressure (BP) has been suggested to be a better estimator of hypertension-associated risks. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of renal organ damage in hypertensive patients. Brachial and central (calculated by an oscillometric system through brachial pulse wave analysis) office BP and ambulatory BP monitoring (ABPM) data and aortic pulse wave velocity (PWV) were measured in 208 hypertensive patients. Renal organ damage was evaluated by means of the albumin to creatinine ratio and the estimated glomerular filtration rate. Fifty-four patients (25.9%) were affected by renal organ damage, displaying either microalbuminuria (urinary albumin excretion ≥30 mg/g creatinine) or an estimated glomerular filtration rate (eGFR) ABPM-derived BP estimates (both central and brachial) showed significant associations with the presence of renal damage. Odds ratios for central BP estimates were not significantly higher than those obtained for brachial BP. Compared with peripheral ABPM, cuff-based oscillometric central ABPM does not show a closer association with presence of renal organ damage in hypertensive patients. More studies, however, need to be done to better identify the role of central BP in clinical practice. © 2017 The Author(s). Published by S. Karger AG, Basel.

  8. Oxidative stress causes renal angiotensin II type 1 receptor upregulation, Na+/H+ exchanger 3 overstimulation, and hypertension.

    Science.gov (United States)

    Banday, Anees A; Lokhandwala, Mustafa F

    2011-03-01

    Oxidative stress modulates angiotensin (Ang) II type 1 receptor (AT(1)R) expression and function. Ang II activates renal Na(+)/H(+) exchanger 3 (NHE3) to increase sodium reabsorption, but the mechanisms are still elusive. In addition, the upregulation of AT(1)R during oxidative stress could promote sodium retention and lead to an increase in blood pressure. Herein, we investigated the mechanism of Ang II-mediated, AT(1)R-dependent renal NHE3 regulation and effect of oxidative stress on AT(1)R signaling and development of hypertension. Male Sprague-Dawley rats received tap water (control) or 30 mmol/L of l-buthionine-sulfoximine, an oxidant, with and without 1 mmol/L of Tempol, an antioxidant, for 3 weeks. l-Buthionine-sulfoximine-treated rats exhibited oxidative stress and high blood pressure. Incubation of renal proximal tubules with Ang II caused significantly higher NHE3 activation in l-buthionine-sulfoximine-treated rats compared with control. The activation of NHE3 was sensitive to AT(1)R blocker and inhibitors of phospholipase C, tyrosine kinase, janus kinase 2 (Jak2), Ca(2+)-dependent calmodulin (CaM), and Ca(2+) chelator. Also, incubation of proximal tubules with Ang II caused Jak2-dependent CaM phosphorylation, which led to Jak2-CaM complex formation and increased Jak2-CaM interaction with NHE3. The activation of these signaling molecules was exaggerated in l-buthionine-sulfoximine-treated rats, whereas Tempol normalized the AT(1)R signaling. In conclusion, Ang II activates renal proximal tubular NHE3 through novel pathways that involve phospholipase C and an increase in intracellular Ca(2+), Jak2, and CaM. In addition, oxidative stress exaggerates Ang II signaling, which leads to overstimulation of renal NHE3 and contributes to an increase in blood pressure.

  9. Maintenance of hypertensive hemodynamics does not depend on ROS in established experimental chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Diana A Papazova

    Full Text Available While the presence of oxidative stress in chronic kidney disease (CKD is well established, its relation to hypertensive renal hemodynamics remains unclear. We hypothesized that once CKD is established blood pressure and renal vascular resistance (RVR no longer depend on reactive oxygen species. CKD was induced by bilateral ablation of 2/3 of each kidney. Compared to age-matched, sham-operated controls all ablated rats showed proteinuria, decreased glomerular filtration rate (GFR, more renal damage, higher mean arterial pressure (MAP, RVR and excretion of oxidative stress markers and hydrogen peroxide, while excretion of stable nitric oxide (NO metabolites tended to decrease. We compared MAP, RVR, GFR and fractional excretion of sodium under baseline and during acute Tempol, PEG-catalase or vehicle infusion in rats with established CKD vs. controls. Tempol caused marked reduction in MAP in controls (96±5 vs.79±4 mmHg, P<0.05 but not in CKD (130±5 vs. 127±6 mmHg. PEG-catalase reduced MAP in both groups (controls: 102±2 vs. 94±4 mmHg, P<0.05; CKD: 118±4 vs. 110±4 mmHg, P<0.05, but did not normalize MAP in CKD rats. Tempol and PEG-catalase slightly decreased RVR in both groups. Fractional excretion of sodium was increased by both Tempol and PEG-catalase in both groups. PEG-catalase decreased TBARS excretion in both groups. In sum, although oxidative stress markers were increased, MAP and RVR did not depend more on oxidative stress in CKD than in controls. Therefore reactive oxygen species appear not to be important direct determinants of hypertensive renal hemodynamics in this model of established CKD.

  10. Treatment of secondary hyperparathyroidism by high calcium diet is associated with enhanced resistance artery relaxation in experimental renal failure.

    Science.gov (United States)

    Jolma, Pasi; Kööbi, Peeter; Kalliovalkama, Jarkko; Saha, Heikki; Fan, Meng; Jokihaara, Jarkko; Moilanen, Eeva; Tikkanen, Ilkka; Pörsti, Ilkka

    2003-12-01

    Vasorelaxation is impaired in renal failure (RF) and hypertension. A high calcium diet enhances vasodilatation and reduces blood pressure in experimental hypertension. Oral calcium salts are used as phosphate binders in RF. However, the effect of increased calcium intake on arterial tone in RF is unknown. We investigated the influence of an 8-week high calcium diet (0.3 vs 3.0%) on resistance artery tone in 5/6 nephrectomized (NTX) rats. Calcium was supplemented as carbonate salt, blood pressure measured by tail-cuff, urine collected in metabolic cages, and samples taken for blood chemistry and parathyroid hormone (PTH). Functional studies of isolated third-order branches of the mesenteric artery in vitro were performed using the Mulvany multimyograph. Plasma urea was elevated 1.6-fold and systolic blood pressure by 10 mmHg after NTX, while increased calcium intake was without effect on these variables. Plasma PTH and phosphate were raised following NTX, and suppressed by high calcium diet. Vasorelaxations induced by K(+) channel agonists 11,12-epoxyeicosatrienoic acid and levcromakalim were impaired after NTX. Vasorelaxation induced by acetylcholine was also reduced following NTX, and experiments with N(G)-nitro-L-arginine methyl ester, diclofenac and charybdotoxin + apamin suggested that the K(+) channel-mediated component of endothelium-dependent relaxation was deficient after NTX. Increased calcium intake corrected all impairments of vasodilatation in NTX rats. Deficient vasorelaxation via K(+) channels was normalized by high calcium diet in experimental RF. This effect was independent of the degree of renal impairment and blood pressure, but was associated with improved calcium metabolism: plasma levels of PTH and phosphate were decreased and ionized calcium was increased.

  11. Renal artery digital-substraction angiography. An outpatient investigation for renovascular hypertension

    International Nuclear Information System (INIS)

    Jackson, B.; Dugdale, L.

    1985-01-01

    The adequacy and convenience of the digital-substraction angiographic procedure by means of a Diasonics DF100 as an investigation in renovascular disease were assessed in 82 renal artery studies. The major advantage of digital subtraction angiography of the renal artery over conventional angiography is that it can be performed on an outpatient basis

  12. Mechanisms of K(+) induced renal vasodilation in normo- and hypertensive rats in vivo

    DEFF Research Database (Denmark)

    Magnusson, Linda Helena Margaretha; Sørensen, Charlotte Mehlin; Braunstein, T H

    2011-01-01

    ) was calculated as the ratio of mean arterial pressure (MAP) and RBF (RVR = MAP/RBF). Test drugs were introduced directly into the renal artery. Inward rectifier K(+) (K(ir) ) channels and Na(+) ,K(+) -ATPase were blocked by Ba(2+) and ouabain (estimated plasma concentrations ~20 and ~7 µm) respectively. Results......: Confocal immunofluorescence microscopy demonstrated K(ir) 2.1 channels in pre-glomerular vessels of SD and SHR. Ba(2+) caused a transient (6-13%) increase in baseline RVR in both SD and SHR. Ouabain had a similar effect. Elevated renal plasma [K(+) ] (~12 mm) caused a small and sustained decrease (5...... the K(+) -induced renal vasodilation. Conclusion: K(+) -induced renal vasodilation is larger in SHR, mediated by K(ir) channels in SD and SHR, and in addition, by Na(+) ,K(+) -ATPase in SD. In addition, NO is not essential for K(+) -induced renal vasodilation....

  13. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  14. Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors

    Directory of Open Access Journals (Sweden)

    Eduardo Pimenta

    2009-06-01

    Full Text Available Eduardo Pimenta1, Suzanne Oparil21Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders, University of Queensland School of Medicine, Greenslopes Princess Alexandra Hospitals, Brisbane, QLD, Australia; 2Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: The renin–angiotensin–aldosterone system (RAAS is a key mediator of blood pressure (BP and volume regulation in both normotensive and hypertensive persons. Stimulation of RAAS also contributes to hypertension-related target organ damage. The renin–angiotensinogen reaction is the first and rate-limiting step in the generation of angiotensin II (Ang II and has been a target of antihypertensive drug development for decades. Aliskiren is the first in a new class of orally effective direct renin inhibitors (DRIs and is approved for the treatment of hypertension in humans. It effectively reduces BP in the general population of hypertensive patients and has a tolerability and safety profile similar to placebo. Aliskiren has favorable effects on vascular inflammation and remodeling, on neurohumoral mediators of various forms of cardiovascular disease, including heart failure, and on proteinuria in diabetic patients. Additional outcome trials are needed to establish the role of this novel class of antihypertensive medication in preventing cardiovascular disease morbidity and mortality.Keywords: hypertension, renin inhibitors, renin-angiotensin-aldosterone system

  15. Exercise induced renal dysfunction demonstrated both in hypertensives and normotensive controls studies by Tc-99m-DTPA

    International Nuclear Information System (INIS)

    Mizuiri, S.; Hayashi, I.; Ohara, T.; Hirata, K.; Sasaki, Y.

    1985-01-01

    It was previously reported that the hippurate transport disturbance after exercise is a specific phenomenon to patients with hypertension. The authors' study with Tc-99m-DTPA revealed exercise induced renal dysfunction not only in hypertensives (H) but also in normotensive controls (N). The details of the investigation is presented. Tc-99m-DTPA was intravenously injected at rest and during bicycle ergometric stress to 14 H and 14 N in sitting position. Serial dynamic renal images were taken, of which data were simultaneously stored in a data processor for later analysis. The renogram was drawn setting ROI on each kidney. Peak counts (PC) of vascular phase, peak time (PT) of secretory phase and radioisotope retention rate (RR) at 10 minutes were the parameters being compared between at rest and at exercise. GFR of each kidney was determined. Blood samples were obtained at rest and at the end of exercise for the measurement of aldosterone (ALD), plasma renin activity (PRA) and catecholamines (A, NA). Exercise caused significant lowering of PC, prolongation of PT and increase in RR (10 min. counts/peak counts) both in H and N. GFR (miota/min.) during exercise was significantly lower than at rest in both H (80 +- 22 vs 93.8 +- 16.9, p<0.02) and N (84 +- 17 vs 102 +- 15, p<0.01). ALD, PRA, A and NA are all elevated during exercise both in H and N. None of the rest-exercise differences significantly differed between H and N. The data indicate the exercise induced renal dysfunction demonstrated by Tc-99m-DTPA renograms is not specified to H but can also be observed in N, which may be resulted from the common changes in H and N of GFR and humoral factors

  16. ABPM vs office blood pressure to define blood pressure control in treated hypertensive paediatric renal transplant recipients.

    Science.gov (United States)

    Ferraris, Jorge R; Ghezzi, Lidia; Waisman, Gabriel; Krmar, Rafael T

    2007-02-01

    While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplants. Controlled office BP was defined as the mean of three replicate systolic and diastolic BP recordings less than or equal to the 95th age-, sex- and height-matched percentile on the three-outpatient visits closest to ABPM. Controlled ABPM was defined as systolic and diastolic daytime BP ABPM reference. Eight recipients (30%) with controlled office BP were in fact categorized as having non-controlled BP by ABPM criteria. Overall, when office BP and ABPM were compared using the Bland and Altman method, the 95% limits of agreement between office and daytime values ranged from -12.6 to 34.1 mmHg for systolic and -23.9 to 31.7 mmHg for diastolic BP, and the mean difference was 10.7 and 3.9 mmHg respectively. Office readings miss a substantial number of recipients who are hypertensive by ABPM criteria. Undertreatment of hypertension could be avoided if ABPM is applied as an adjunct to office readings.

  17. Angiotensin II clamp prevents the second step in renal apical NHE3 internalization during acute hypertension

    DEFF Research Database (Denmark)

    Leong, Patrick K K; Yang, Li E; McDonough, Alicia A

    2002-01-01

    Acute hypertension inhibits proximal tubule (PT) sodium reabsorption. The resultant increase in NaCl delivery to the macula densa suppresses renin release. We tested whether the sustained pressure-induced inhibition of PT sodium reabsorption requires a renin-mediated decrease in ANG II levels...... hypertension, including diuresis and redistribution of PT NHE3 into intracellular membranes, require a responsive renin-angiotensin system and that the responses may be induced by the sustained increase in NaCl delivery to the macula densa during acute hypertension....

  18. Magnetic resonance imaging of renal ischemia experimentally induced by renal artery ligation

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Han, Moon Hee; Han, Joon Koo; Kim, Seung Hyup; Choi, Byung Ihn; Han, Man Chung; Kim, Chu Wan; Suh, Chang Hae; Choi, Yo Won

    1992-01-01

    This study was designed to evaluate the potential applications of magnetic resonance imaging for the diagnosis of early and sequential changes of acute renal ischemia. Renal ischemia was induced in seventeen rabbits by surgical ligation of the left renal artery. Magnetic resonance imaging (MRI) was performed with a 2.0T superconductive MR system and a spin-echo technique was used with echo times(TE) of 30 and 80 msec and repetition times (TR) of 0.5 and 2.5 seconds. Kidneys were evaluated before and up to 48 hours after left renal artery ligation, and the spin echo images were analyzed for intensity difference and T1, T2 relaxation times between the cortex and the medulla of both kidneys. After one, and one and half hour following ligation of the left renal artery, the kidneys showed a 4-20% decrease in the left cortex compared to the right cortex contrast uptake (CCC) (ρ < 0.01). There was a 14-29% decrease in left medulla to right medulla contrast uptake (MMC) (ρ < 0.01). A 29-147% increase in contrast uptake was noted when the left cortex was compared to the left medulla (ρ < 0.05). There was a 51-68% decrease in CMC of the right kidney (ρ < 0.05) on three different spin echo images. In the cortex of the left kidney, T2 relaxation time decreased 14% (ρ < 0.01). CCC and MMC showed more prominent changes than CMC, and sequential changes of CCC and MMC were most prominent on T2 weighted images with TR=2.5sec and TE=80msec when compared with T1 weighted and proton density weighted images. Twelve hours after renal arterial ligation, T2 relaxation time, CMC, CCC, and MCC returned to normal values and these findings were believed to be due to congestion and collateral blood supply. In renal ischemia, the most useful MRI findings for diagnosis were found to be changes of CCC and MMC on T2 weighted image, and T2 relaxation time of the cortex in the ischemic kidney

  19. Maternal diet during gestation and lactation modifies the severity of salt-induced hypertension and renal injury in Dahl salt-sensitive rats.

    Science.gov (United States)

    Geurts, Aron M; Mattson, David L; Liu, Pengyuan; Cabacungan, Erwin; Skelton, Meredith M; Kurth, Theresa M; Yang, Chun; Endres, Bradley T; Klotz, Jason; Liang, Mingyu; Cowley, Allen W

    2015-02-01

    Environmental exposure of parents or early in life may affect disease development in adults. We found that hypertension and renal injury induced by a high-salt diet were substantially attenuated in Dahl SS/JrHsdMcwiCrl (SS/Crl) rats that had been maintained for many generations on the grain-based 5L2F diet compared with SS/JrHsdMcwi rats (SS/Mcw) maintained on the casein-based AIN-76A diet (mean arterial pressure, 116±9 versus 154±25 mm Hg; urinary albumin excretion, 23±12 versus 170±80 mg/d). RNAseq analysis of the renal outer medulla identified 129 and 82 genes responding to a high-salt diet uniquely in SS/Mcw and SS/Crl rats, respectively, along with minor genetic differences between the SS substrains. The 129 genes responding to salt in the SS/Mcw strain included numerous genes with homologs associated with hypertension, cardiovascular disease, or renal disease in human. To narrow the critical window of exposure, we performed embryo-transfer experiments in which single-cell embryos from 1 colony (SS/Mcw or SS/Crl) were transferred to surrogate mothers from the other colony, with parents and surrogate mothers maintained on their respective original diet. All offspring were fed the AIN-76A diet after weaning. Salt-induced hypertension and renal injury were substantially exacerbated in rats developed from SS/Crl embryos transferred to SS/Mcw surrogate mothers. Conversely, salt-induced hypertension and renal injury were significantly attenuated in rats developed from SS/Mcw embryos transferred to SS/Crl surrogate mothers. Together, the data suggest that maternal diet during the gestational-lactational period has substantial effects on the development of salt-induced hypertension and renal injury in adult SS rats. © 2014 American Heart Association, Inc.

  20. Hydronephrosis causes salt-sensitive hypertension and impaired renal concentrating ability in mice

    DEFF Research Database (Denmark)

    Carlström, M; Sällström, J; Skøtt, O

    2007-01-01

    salt-sensitive hypertension that correlated to the degree of hydronephrosis. In hydronephrotic animals, blood pressure increased from 114 +/- 1 mmHg on normal salt diet to 120 +/- 2 mmHg on high salt diet, compared with 103 +/- 1 to 104 +/- 1 in controls. Hydronephrotic animals showed increased......AIM: Hypertension is a common disease in the industrialized world and approximately 5% of all cases are secondary to kidney malfunction. We have recently shown that hydronephrosis due to partial unilateral ureteral obstruction (PUUO) causes salt-sensitive hypertension in rats. The mechanisms...... are still unclear, but appear to be intrarenal and primarily located to the diseased kidney. In the present study, we have developed a model for PUUO to study if hydronephrotic mice develop salt-sensitive hypertension. METHODS: PUUO was created in 3-week-old mice (C57bl/6J). Blood pressure and heart rate...

  1. Comparative risk of renal, cardiovascular, and mortality outcomes in controlled, uncontrolled resistant, and non-resistant hypertension

    Science.gov (United States)

    Sim, John J.; Bhandari, Simran K.; Shi, Jiaxiao; Reynolds, Kristi; Calhoun, David A.; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

    2015-01-01

    We sought to compare the risk of end stage renal disease (ESRD), ischemic heart event (IHE), congestive heart failure (CHF), cerebrovascular accident (CVA), and all-cause mortality among 470,386 individuals with resistant and nonresistant hypertension (non-RH). Resistant hypertension (60,327 individuals) was sub-categorized into 2 groups; 23,104 patients with cRH (controlled on 4 or more medicines) and 37,223 patients with uRH (uncontrolled on 3 or more medicines) in a 5 year retrospective cohort study. Cox proportional hazard modeling was used to estimate hazard ratios adjusting for age, gender, race, body mass index, chronic kidney disease (CKD), and co-morbidities. Resistant hypertension (cRH and uRH) compared to non-RH, had multivariable adjusted hazard ratios (95% confidence intervals) of 1.32 (1.27–1.37), 1.24 (1.20–1.28), 1.46 (1.40–1.52), 1.14 (1.10–1.19), and 1.06 (1.03–1.08) for ESRD, IHE, CHF, CVA, and mortality, respectively. Comparison of uRH to cRH had hazard ratios of 1.25 (1.18–1.33), 1.04 (0.99–1.10), 0.94 (0.89–1.01), 1.23 (1.14–1.31), and 1.01 (0.97–1.05) for ESRD, IHE, CHF, CVA, and mortality, respectively. Males and Hispanics had greater risk for ESRD within all 3 cohorts. Resistant hypertension had greater risk for ESRD, IHE, CHF, CVA, and mortality. The risk of ESRD and CVA and were 25% and 23% greater, respectively, in uRH compared to cRH supporting the linkage between blood pressure and both outcomes. PMID:25945406

  2. LONG-TERM EFFECTS OF PROTEIN-RESTRICTED DIET ON ALBUMINURIA AND RENAL-FUNCTION IN IDDM PATIENTS WITHOUT CLINICAL NEPHROPATHY AND HYPERTENSION

    NARCIS (Netherlands)

    DULLAART, RPF; BEUSEKAMP, BJ; MEIJER, S; VANDOORMAAL, JJ; SLUITER, WJ

    OBJECTIVES - To determine the long-term effects of an LPD on albuminuria and renal hemodynamics in IDDM patients without nephropathy. RESEARCH DESIGN AND METHODS - We selected 31 patients with overnight albuminuria between 10 and 200 g/min and without hypertension from a referral-based diabetic

  3. Expression and response to angiotensin-converting enzyme inhibition of matrix metalloproteinases 2 and 9 in renal glomerular damage in young transgenic rats with renin-dependent hypertension

    NARCIS (Netherlands)

    Bolbrinker, J; Markovic, S; Wehland, M; Melenhorst, WBWH; van Goor, H; Kreutz, R

    Extracellular matrix expansion in the glomerular mesangium contributes to the development of glomerulosclerosis and chronic renal disease in arterial hypertension. Transforming growth factor-beta 1 (TGF-beta 1), matrix metalloproteinases (MMPs), and tissue inhibitors of MMPs (TIMPs) are involved in

  4. 2-Methoxyestradiol Reduces Angiotensin II-Induced Hypertension and Renal Dysfunction in Ovariectomized Female and Intact Male Mice.

    Science.gov (United States)

    Pingili, Ajeeth K; Davidge, Karen N; Thirunavukkarasu, Shyamala; Khan, Nayaab S; Katsurada, Akemi; Majid, Dewan S A; Gonzalez, Frank J; Navar, L Gabriel; Malik, Kafait U

    2017-06-01

    Cytochrome P450 1B1 protects against angiotensin II (Ang II)-induced hypertension and associated cardiovascular changes in female mice, most likely via production of 2-methoxyestradiol. This study was conducted to determine whether 2-methoxyestradiol ameliorates Ang II-induced hypertension, renal dysfunction, and end-organ damage in intact Cyp1b1 -/- , ovariectomized female, and Cyp1b1 +/+ male mice. Ang II or vehicle was infused for 2 weeks and administered concurrently with 2-methoxyestradiol. Mice were placed in metabolic cages on day 12 of Ang II infusion for urine collection for 24 hours. 2-Methoxyestradiol reduced Ang II-induced increases in systolic blood pressure, water consumption, urine output, and proteinuria in intact female Cyp1b1 -/- and ovariectomized mice. 2-Methoxyestradiol also reduced Ang II-induced increase in blood pressure, water intake, urine output, and proteinuria in Cyp1b1 +/+ male mice. Treatment with 2-methoxyestradiol attenuated Ang II-induced end-organ damage in intact Cyp1b1 -/- and ovariectomized Cyp1b1 +/+ and Cyp1b1 -/- female mice and Cyp1b1 +/+ male mice. 2-Methoxyestradiol mitigated Ang II-induced increase in urinary excretion of angiotensinogen in intact Cyp1b1 -/- and ovariectomized Cyp1b1 +/+ and Cyp1b1 -/- female mice but not in Cyp1b1 +/+ male mice. The G protein-coupled estrogen receptor 1 antagonist G-15 failed to alter Ang II-induced increases in blood pressure and renal function in Cyp1b1 +/+ female mice. These data suggest that 2-methoxyestradiol reduces Ang II-induced hypertension and associated end-organ damage in intact Cyp1b1 -/- , ovariectomized Cyp1b1 +/+ and Cyp1b1 -/- female mice, and Cyp1b1 +/+ male mice independent of G protein-coupled estrogen receptor 1. Therefore, 2-methoxyestradiol could serve as a therapeutic agent for treating hypertension and associated pathogenesis in postmenopausal females, and in males. © 2017 American Heart Association, Inc.

  5. Clinical profile and management of hypertensive patients with chronic ischemic heart disease and renal dysfunction attended by cardiologists in daily clinical practice.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Murga, Nekane; de Pablo, Carmen; Bertomeu, Vicente; Calderón, Alberto; Echarri, Rocio

    2008-11-01

    The present study was designed to assess the influence of renal function on the clinical profile and management of the hypertensive outpatients with chronic ischemic heart disease. A total of 112 investigators, all cardiologists, were asked to consecutively enrol outpatients of at least 18 years of age, both sexes, with an established diagnosis of hypertension and chronic ischemic heart disease. Renal function was assessed by serum creatinine levels and estimated glomerular filtration rate using the Modification of Diet in Renal Disease formula. Renal impairment was considered a serum creatinine of at least 1.2/1.3 mg/dl (women/men) or an estimated glomerular filtration rate less than 60 ml/min/1.73 m2. Blood pressure was considered controlled when it was less than 140/90 mmHg and less than 130/80 mmHg in diabetic patients or patients with chronic kidney disease. A total of 2024 patients (66.8+/-10.1 years; 31.7% women) were included. A total of 666 (32.9%) and 498 (24.6%) patients exhibited renal function impairment assessed by estimated glomerular filtration rate and serum creatinine, respectively. The subgroup of patients with renal dysfunction was older, with a higher proportion of women with atrial fibrillation, diabetes, organ damage, associated clinical conditions and a worse blood pressure control. No differences were found in clinical profile when the two subgroups of patients with impaired renal function [serum creatinine >or=1.2/>or=1.3 mg/dl (women/men) vs. estimated glomerular filtration rate <60 ml/min per 1.73 m2] were compared. Renal function impairment is frequent in the hypertensive population with coronary artery disease. Patients with renal dysfunction represent a subgroup of very high-risk population with more risk factors and comorbidities and worse blood pressure control. The clinical profiles of hypertensive patients with renal function impairment are similar whether renal dysfunction is detected by high serum creatinine or by low estimated

  6. Plasma proteomics classifiers improve risk prediction for renal disease in patients with hypertension or type 2 diabetes

    DEFF Research Database (Denmark)

    Pena, Michelle J; Jankowski, Joachim; Heinze, Georg

    2015-01-01

    OBJECTIVE: Micro and macroalbuminuria are strong risk factors for progression of nephropathy in patients with hypertension or type 2 diabetes. Early detection of progression to micro and macroalbuminuria may facilitate prevention and treatment of renal diseases. We aimed to develop plasma...... and the Steno Diabetes Center. Cases transitioned from normo to microalbuminuria, or from micro to macroalbuminuria. Controls, matched for age, sex, and baseline albuminuria stage, did not transition. Follow-up was 3.0 ± 0.9 years. Plasma proteomics profiles were measured by liquid chromatography......-electrospray-trap mass-spectrometry. Classifiers were developed and cross-validated for prediction of transition in albuminuria stage. Improvement in risk prediction was tested on top of a reference model of baseline albuminuria, estimated glomerular filtration rate, and renin-angiotensin-aldosterone system intervention...

  7. Índice de resistividade renal como preditor da revascularização renal para hipertensão renovascular Índice de resistividad renal como predictor de la revascularización renal para hipertensión renovascular Renal resistance index predicting outcome of renal revascularization for renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Simone N. Santos

    2010-04-01

    exitosa, ni todos los pacientes (pt expresan mejora clínica y algunos pueden empeorar. OBJETIVO: El presente estudio está destinado a evaluar el valor del índice de resistividad renal (IR como predictor de los efectos de la revascularización renal. MÉTODOS: Entre enero de 1998 y febrero de 2001, 2933 pacientes se sometieron al ultrasonido Doppler dúplex renal. Un total de 106 de estos pacientes expresaron EAR significativa y fueron sometidos a angiografía y revascularización renal. Se midió la presión arterial (PA antes y después de la intervención, en intervalos de hasta 2 años y las medicaciones prescriptas fueron registradas. Antes de la revascularización, el IR se midió en 3 locales del riñón, con la obtención de un promedio de estas mediciones. RESULTADOS: De los 106 pacientes, 81 tuvieron IR 80. La EAR se corrigió solamente por angioplastia (PTA en 25 pts, PTA + stent en 56 pts y quirúrgicamente en 25 pts. De los pacientes que se beneficiaron de la revascularización renal; 57 de los 81 pacientes con IR 80. Usando un modelo de regresión logística múltiple, el IR estuvo significativamente asociado a la evolución de la PA (p = 0,001, ajustado de acuerdo con los efectos de la edad, sexo, PAS, PAD, duración de la hipertensión, el tipo de revascularização, número de fármacos en uso, nivel de creatinina, presencia de DM, hipercolesterolemia, volumen sistólico, enfermedad arterial periférica y coronaria y tamaño renal (OR 99,6-95%CI para OR 6,1-1.621,2. CONCLUSIÓN: La resistividad intrarrenal arterial, medida por ultrasonido Doppler dúplex, desempeña un rol importante en la predicción de los efectos post revascularização renal para EAR.BACKGROUND: Renal artery stenosis (RAS is a potentially correctable cause of hypertension and ischemic nephropathy. Despite successful renal revascularization, not all patients (pt overcome it and some get worse. OBJECTIVE: This study was designed to assess the value of renal resistance index (RI in

  8. The Prevalence of Japanese Outpatients with Hypertension Who Meet the Definition of Treatment Resistant Hypertension and Are Eligible for Enrolment in Clinical Trials of Endovascular Ultrasound Renal Denervation.

    Science.gov (United States)

    Okamura, Keisuke; Shirai, Kazuyuki; Okuda, Tetsu; Urata, Hidenori

    2018-01-01

    Objective A clinical trial (REQUIRE) was started to investigate the use of an ultrasound renal denervation system in the treatment of resistant hypertension (RHT). We analyzed the prevalence of patients who were eligible for inclusion in this cross-sectional study at the time of screening. Methods Nine-hundred ninety-nine consecutive hypertension (HT) patients who were treated in our hospital as outpatients were classified into the following categories: patients treated with at least 3 types of antihypertensive drugs including diuretic agents who were eligible for enrolment in SYMPLICITY HTN-Japan (SH-J) with an office systolic blood pressure (SBP) of ≥160 mmHg, who were ≤80 years of age, and an estimated glomerular filtration rate (eGFR) of ≥45 mL/min/1.73 m 2 (RHT-S); and patients who were treated similar medications and who were eligible for enrolment in REQUIRE, with an SBP of ≥150 mmHg, ≤75 years of age, and an eGFR of ≥40 mL/min/1.73 m 2 (RHT-R). We investigated the proportion of patients in each category. We also investigated HT patients (1,423 cases) who were enrolled in the Chikushi Anti-Hypertension Trial (CHAT), a research network that includes general practitioners. Results Eleven patients (1.1%) with RHT-S and 18 patients (1.8%) with RHT-R were identified. After the exclusion of patients with secondary HT and a diastolic blood pressure (DBP) of <90 mmHg (applied in REQUIRE), 5 patients (0.5%) with RHT-S and 4 patients (0.4%) with RHT-R remained. In the analysis of the CHAT study, only 2 (0.1%) patients with RHT-R remained. Conclusion The number of eligible patients in the REQUIRE trial was decreased, largely due to the strict age restriction and the new DBP limitation. The prevalence of eligible patients in REQUIRE was estimated to be approximately 0.5 to 0.8 times that in SH-J. Since patient enrollment will be difficult, drastic measures may be required to recruit eligible patients.

  9. Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice Alteración del patrón hormonal regulatorio renal durante la ictericia obstructiva experimental

    Directory of Open Access Journals (Sweden)

    F. J Padillo

    2009-06-01

    Full Text Available Objective: the alteration of hormones regulating sodium and water status is related to renal failure in obstructive jaundice (OJ. Experimental design: OJ was induced by common bile duct ligation. Samples were obtained from the control (SO and OJ groups at 24 and 72 hours, and at 7 days. Different parameters related to biliary obstruction, liver and renal injury, and vasoactive mediators such as renin, aldosterone, endothelin-1 (ET-1 and prostaglandin E2 (PGE2 were studied. Results: bile duct ligation caused an increase in total bilirubin (p < 0.001 and alkaline phosphatase (AP (p < 0.001. The SO and OJ groups had the same values for diuresis, renin, and creatinine clearance at 24 h. However, animals with OJ had a lower sodium concentration in urine than SO animals (p < 0.01, as well as an increase in aldosterone levels (p < 0.03. ANP levels were moderately increased during OJ but did not reach statistical significance when compared to the SO group. In contrast, OJ animals showed a rise in serum ET-1 concentration (p < 0.001 and increased PGE2 in urine (p < 0.001. Conclusions: biliary obstruction induced an increase in ET-1 release and PGE2 urine excretion. These hormones might play a role during the renal complications associated with renal disturbances that occur during OJ.

  10. The exenatide analogue AC3174 attenuates hypertension, insulin resistance, and renal dysfunction in Dahl salt-sensitive rats

    Directory of Open Access Journals (Sweden)

    Fernandez Rayne

    2010-08-01

    Full Text Available Abstract Background Activation of glucagon-like peptide-1 (GLP-1 receptors improves insulin sensitivity and induces vasodilatation and diuresis. AC3174 is a peptide analogue with pharmacologic properties similar to the GLP-1 receptor agonist, exenatide. Hypothetically, chronic AC3174 treatment could attenuate salt-induced hypertension, cardiac morbidity, insulin resistance, and renal dysfunction in Dahl salt-sensitive (DSS rats. Methods DSS rats were fed low salt (LS, 0.3% NaCl or high salt (HS, 8% NaCl diets. HS rats were treated with vehicle, AC3174 (1.7 pmol/kg/min, or GLP-1 (25 pmol/kg/min for 4 weeks via subcutaneous infusion. Other HS rats received captopril (150 mg/kg/day or AC3174 plus captopril. Results HS rat survival was improved by all treatments except GLP-1. Systolic blood pressure (SBP was lower in LS rats and in GLP-1, AC3174, captopril, or AC3174 plus captopril HS rats than in vehicle HS rats (p Conclusions Thus, AC3174 had antihypertensive, cardioprotective, insulin-sensitizing, and renoprotective effects in the DSS hypertensive rat model. Furthermore, AC3174 improved animal survival, an effect not observed with GLP-1.

  11. Renal risk-benefit determinants of recombinant human erythropoietin therapy in the remnant kidney rat model - hypertension, anaemia, inflammation and drug dose.

    Science.gov (United States)

    Ribeiro, Sandra; Garrido, Patrícia; Fernandes, João; Vala, Helena; Rocha-Pereira, Petronila; Costa, Elísio; Belo, Luís; Reis, Flávio; Santos-Silva, Alice

    2016-03-01

    Clinical studies showed that high doses of recombinant human erythropoietin (rHuEPO) used to correct anaemia in chronic kidney disease (CKD) hyporesponsive patients may lead to deleterious effects. The aim of this study was to analyze the effects of rHuEPO in doses usually used to correct CKD-anaemia (100, 200 IU/kg body weight (BW) per week) and in higher doses used in the treatment of hyporesponsive patients (400, 600 IU/kg BW per week), focusing on renal damage, hypoxia, inflammation and fibrosis. Male Wistar rats with chronic renal failure (CRF) induced by 5/6 nephrectomy were treated with rHuEPO or with vehicle, over a 3-week period. Haematological, biochemical and renal function analyses were performed. Kidney and liver mRNA levels were evaluated by quantitative real-time polymerase chain reaction (qPCR) and protein expression by Western blot and immunohistochemistry. Kidney histopathological evaluations were also performed. The CRF group developed anaemia, hypertension and a high score of renal histopathologic lesions. Correction of anaemia was achieved with all rHuEPO doses, with improvement in hypertension, renal function and renal lesions. In addition, the higher rHuEPO doses also improved inflammation. Blood pressure was reduced in all rHuEPO-treated groups, compared to the CRF group, but increased in a dose-dependent manner. The current study showed that rHuEPO treatment corrected anaemia and improved urinary albumin excretion, particularly at lower doses. In addition, it is suggested that a short-term treatment with high doses, used to overcome an episode of hyporesponsiveness to rHuEPO therapy, can present benefits by reducing inflammation, without worsening of renal lesions; however, the pro-hypertensive effect should be considered, and carefully managed to avoid a negative cardiorenal impact. © 2016 John Wiley & Sons Australia, Ltd.

  12. Renal responses to long-term carotid baroreflex activation therapy in patients with drug-resistant hypertension.

    Science.gov (United States)

    Alnima, Teba; de Leeuw, Peter W; Tan, Frans E S; Kroon, Abraham A

    2013-06-01

    Carotid baroreflex activation has been demonstrated to provide enduring reductions in arterial blood pressure. The aim of this study was to investigate the effect of long-term therapy on renal function. A total of 322 patients were enrolled in the Rheos Pivotal Trial. Group 1 consisted of 236 patients who started baroreflex activation therapy 1 month after device implantation, whereas in the 86 patients from group 2 the device was activated 6 months later. Serum creatinine and urine albumin/creatinine ratio were collected at screening (before device activation), and at months 6 and 12. Multilevel statistical analyses were adjusted for various covariables. Serum creatinine increased from 78 to 84 μmol/L, and glomerular filtration rate decreased from 92 to 87 mL/min per 1.73 m(2) in group 1 at month 6 (Pbaroreflex activation therapy in hypertensive patients is associated with an initial mild decrease in glomerular filtration rate, which may be considered as a normal hemodynamic response to the drop in blood pressure. Long-term treatment does not result in further decrease in renal function, indicating baroreflex activation as a safe and effective therapy.

  13. [Clinical and experimental studies on the pathogenesis in pregnancy induced hypertension].

    Science.gov (United States)

    Hidaka, A

    1988-08-01

    Placental ischemia is one of the etiological factors of pregnancy induced hypertension (PIH), however, the pathogenesis of placental and renal ischemia has not been clarified. The purposes of this investigation are (1) to clarify the fetomaternal hemodynamic changes in PIH and the influence of maternal postural change on fetomaternal hemodynamics, measured by thermodilution method, impedance cardiography and pulsed doppler method during pregnancy, (2) to provide to relationship between intrauterine resting tonus and maternal hemodynamics, that is, blood pressure, placental and renal blood flow measured by electromagnetic flowmeter and thermocouple method, and renal nerve activity, and (3) to study the influence of placental ischemia on vascular sensitivity to angiotensin II measured by Magnus method in animal experiment. (1) The increase in C.O and blood volume were recognized from the beginning of pregnancy to 24 GW, and subsequently, the decreasing tendency were found from about 32 GW to the onset of labor. However this decreasing tendency were subsided in the lateral position. These circulatory changes were observed in both normotensive and PIH cases, and especially, the decrease in C.O and blood volume in late pregnancy were more remarkable in PIH than that in normotensive pregnancy. From the results of Starling curve, left ventricular work was more hyperdynamic status in PIH than that in normotensive pregnancy, these results show that there are a compensatory mechanism against high vascular resistance in PIH. A/B (S/D) ratio in uterine artery, umbilical artery and fetal aorta were lowered in II-nd and III-rd trimester and more decreased in the lateral position from the supine position, on the other hand these ratio in PIH were elevated respectively. These results show that there are the aortocaval compression by the heavy tensive uterus and subsequent sluice flow mechanism in fetoplacental circulation in the supine position in late pregnancy. (2) These

  14. Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

    NARCIS (Netherlands)

    de Beus, Esther; de Jager, Rosa L; Beeftink, Martine M; Sanders, Margreet F; Spiering, Wilko; Vonken, Evert-Jan; Voskuil, Michiel; Bots, Michiel L; Blankestijn, Peter J; de Wit, G.A.; van Maarseveen, E.M.

    2017-01-01

    The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely,

  15. Effect of astragalus and dopamine on changes of blood and renal tissue contents of NO, ET in experimental rat models of acute renal failure

    International Nuclear Information System (INIS)

    Wu Yajun; Zheng Bingjie; Shi Lan; Fan Yaping

    2004-01-01

    Objective: To explore the effect of intravenous or intra-renal-capsular administration of astragalus and dopamine on the serum NO and renal tissue NO, ET contents in rat models of acute renal failure. Methods: Experimental rat models of acute renal failure induced by intraperitoneal injection of E. Coli endotoxin (lipo-polysaccharide) were prepared (n=60). Treatment with astragalus and dopamine was administered via either intravenous on intra-renal-capsular route (n=20 in each group). Serum NO and renal tissue NO (with nitric acid reductase method), ET (with RIA) contents were determined at 4, 8, 12, 16h after injection of endotoxin. Twenty shock models were left untreated and additional twenty rats receiving saline injection only served as controls. Results: In the intravenously treated group, the increase of serum NO and renal tissue NO, ET contents were significantly less than those in the untreated group (P<0.05). In the group treated via the intracapsular route , the increase of renal tissue NO and ET contents were much less than those in the intravenous group at 12 and 16h (P<0.05). Conclusion: Combined treatment with astragalus and dopamine could abate the abnormally high renal tissue contents of NO and ET after endotoxin shock in experimental rats and treatment with intra capsular administration seems to be more effective. (authors)

  16. Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study

    Directory of Open Access Journals (Sweden)

    Nakayama Tomohiro

    2011-08-01

    Full Text Available Abstract Background Angiotensin II receptor blockers (ARBs, including olmesartan and candesartan, are widely used antihypertensive agents. Many clinical studies have demonstrated that ARBs have organ-protecting effects, e.g., cardioprotection, vasculoprotection and renoprotection. However, the effect of prolonged olmesartan monotherapy on lipid metabolism in patients with hypertension is less well studied. We performed a retrospective observational study to compare the effects of olmesartan with those of candesartan, focusing on lipid metabolism and renal function. Methods We used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and Feb 28, 2011, to identify cohorts of new olmesartan users (n = 168 and candesartan users (n = 266. We used propensity-score weighting to adjust for differences in all covariates (age, sex, comorbid diseases, previous drugs between olmesartan and candesartan users, and compared serum chemical data including serum triglyceride (TG, LDL-cholesterol (LDL-C, total cholesterol (TC, potassium, creatinine and urea nitrogen. The mean exposure of olmesartan and candesartan users was 126.1 and 122.8 days, respectively. Results After adjustment, there were no statistically significant differences in all covariates between olmesartan and candesartan users. The mean age was 60.7 and 61.0 years, and 33.4% and 33.7% of olmesartan and candesartan users were women, respectively. There were no statistically significant differences in mean values for all laboratory tests between baseline and during the exposure period in both olmesartan and candesartan users. In olmesartan users, the reduction of serum TG level was significant in comparison with that in candesartan users. Other parameters of lipid profile and renal function showed no statistically significant difference in the change from baseline to during the exposure period between olmesartan and candesartan users. Conclusions

  17. HbA1c is an Independent Determinant of Renal Vascular Resistance Estimated by Doppler Sonography in Non-Diabetic Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Ken-ichi Miyoshi

    2008-01-01

    Full Text Available Background Diabetic nephropathy is a progressive disease that leads to renal failure and end stage renal disease. A frequent and early manifestation of diabetic nephropathy is hyaline arteriolosclerosis. The noninvasive method for estimating the severity of arteriolosclerosis is measurement of the renal resistive index (RI. In this study, we determined whether or not normal blood glucose control, classified as an HbA1c < 5.8%, was a sufficiently low level to prevent arteriolosclerosis in patients with essential hypertension. Methods The study subjects were 93 patients with essential hypertension with HbA1c levels <5.8%. Patients with a history of medication for diabetes mellitus were excluded. Blood flow velocity of the renal interlobar arteries was assessed by a Doppler ultrasonography and the RI calculated. Results RI correlated positively with age, body mass index, pulse pressure, pulse rate and HbA1c, and negatively with diastolic blood pressure. A multivariate analysis identified age, pulse pressure and HbA1c as significant independent determinants of RI. Our data show that RI correlates with HbA1c independent of other variables, even in normoglycemic patients with HbA1c levels <5.8%. Conclusions The results of this cross-sectional study suggest that blood glucose levels should be kept as low as possible in order to prevent arteriolosclerosis in the kidney in hypertensive patients.

  18. Renal nerve ultrastructural alterations in short term and long term experimental diabetes.

    Science.gov (United States)

    Sato, Karina Laurenti; Sanada, Luciana Sayuri; Ferreira, Renata da Silva; de Marco, Maria Carolina Del Bem de Barros Oliveti; Castania, Jaci Airton; Salgado, Helio Cesar; Nessler, Randy Alan; Fazan, Valeria Paula Sassoli

    2014-01-05

    Despite the evidence that renal hemodynamics is impaired in experimental diabetes, associated with glomeruli structural alterations, renal nerves were not yet investigated in experimental models of diabetes and the contribution of nerve alterations to the diabetic nephropathy remains to be investigated. We aimed to determine if ultrastructural morphometric parameters of the renal nerves are affected by short term and/or long term experimental diabetes and if insulin treatment reverses these alterations. Left renal nerves were evaluated 15 days or 12 weeks (N = 10 in each group) after induction of diabetes, with a single injection of streptozotocin (STZ). Control rats (N = 10 in each group) were injected with vehicle (citrate buffer). Treated animals (N = 10 in each group) received a single subcutaneous injection of insulin on a daily basis. Arterial pressure, together with the renal nerves activity, was recorded 15 days (short-term) or 12 weeks (long-term) after STZ injection. After the recordings, the renal nerves were dissected, prepared for light and transmission electron microscopy, and fascicle and fibers morphometry were carried out with computer software. The major diabetic alteration on the renal nerves was a small myelinated fibers loss since their number was smaller on chronic diabetic animals, the average morphometric parameters of the myelinated fibers were larger on chronic diabetic animals and distribution histograms of fiber diameter was significantly shifted to the right on chronic diabetic animals. These alterations began early, after 15 days of diabetes induction, associated with a severe mitochondrial damage, and were not prevented by conventional insulin treatment. The experimental diabetes, induced by a single intravenous injection of STZ, in adult male Wistar rats, caused small fiber loss in the renal nerves, probably due to the early mitochondrial damage. Conventional treatment with insulin was able to correct the weight gain and metabolic

  19. Renal Dysfunction Induced by Kidney-Specific Gene Deletion of Hsd11b2 as a Primary Cause of Salt-Dependent Hypertension.

    Science.gov (United States)

    Ueda, Kohei; Nishimoto, Mitsuhiro; Hirohama, Daigoro; Ayuzawa, Nobuhiro; Kawarazaki, Wakako; Watanabe, Atsushi; Shimosawa, Tatsuo; Loffing, Johannes; Zhang, Ming-Zhi; Marumo, Takeshi; Fujita, Toshiro

    2017-07-01

    Genome-wide analysis of renal sodium-transporting system has identified specific variations of Mendelian hypertensive disorders, including HSD11B2 gene variants in apparent mineralocorticoid excess. However, these genetic variations in extrarenal tissue can be involved in developing hypertension, as demonstrated in former studies using global and brain-specific Hsd11b2 knockout rodents. To re-examine the importance of renal dysfunction on developing hypertension, we generated kidney-specific Hsd11b2 knockout mice. The knockout mice exhibited systemic hypertension, which was abolished by reducing salt intake, suggesting its salt-dependency. In addition, we detected an increase in renal membrane expressions of cleaved epithelial sodium channel-α and T53-phosphorylated Na + -Cl - cotransporter in the knockout mice. Acute intraperitoneal administration of amiloride-induced natriuresis and increased urinary sodium/potassium ratio more in the knockout mice compared with those in the wild-type control mice. Chronic administration of amiloride and high-KCl diet significantly decreased mean blood pressure in the knockout mice, which was accompanied with the correction of hypokalemia and the resultant decrease in Na + -Cl - cotransporter phosphorylation. Accordingly, a Na + -Cl - cotransporter blocker hydrochlorothiazide significantly decreased mean blood pressure in the knockout mice. Chronic administration of mineralocorticoid receptor antagonist spironolactone significantly decreased mean blood pressure of the knockout mice along with downregulation of cleaved epithelial sodium channel-α and phosphorylated Na + -Cl - cotransporter expression in the knockout kidney. Our data suggest that kidney-specific deficiency of 11β-HSD2 leads to salt-dependent hypertension, which is attributed to mineralocorticoid receptor-epithelial sodium channel-Na + -Cl - cotransporter activation in the kidney, and provides evidence that renal dysfunction is essential for developing the

  20. Identification of renal Cd36 as a determinant of blood pressure and risk for hypertension

    Czech Academy of Sciences Publication Activity Database

    Pravenec, Michal; Churchill, P. C.; Churchill, M. C.; Vyklický, O.; Kazdová, L.; Aitman, T. J.; Petretto, E.; Hubner, N.; Wallace, C. A.; Zimdahl, H.; Zídek, Václav; Landa, Vladimír; Dunbar, J.; Bidani, A.; Griffin, K.; Qi, N.; Maxová, M.; Křen, Vladimír; Mlejnek, Petr; Wang, J.; Kurtz, T. W.

    2008-01-01

    Roč. 40, č. 8 (2008), s. 952-954 ISSN 1061-4036 R&D Projects: GA MZd(CZ) NR8545; GA MZd(CZ) NR8495; GA MŠk(CZ) 1M0520; GA MŠk(CZ) ME08006; GA MŠk(CZ) 1P05ME791; GA MZd(CZ) NR9359; GA AV ČR(CZ) IAA500110604; GA AV ČR(CZ) IAA500110805 Grant - others:HHMI(US) 55005624; EC(XE) LSHG-CT-2005-019015 Institutional research plan: CEZ:AV0Z50110509 Keywords : spontaneously hypertensive rat * Cd36 * hypertension Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 30.259, year: 2008

  1. Nuclear magnetic resonance. Present results and its application to renal pathology. Experimental study of hydronephrosis

    International Nuclear Information System (INIS)

    Bertrand, P.

    1987-01-01

    Results of proton nuclear magnetic resonance imaging and relaxation time measurement of experimental hydronephrosis in mice are presented. The study is preceded by a description of the physical principles underlying the phenomenon of nuclear magnetic resonance and of its biomedical applications and with a review of the clinical use of NMR imaging in renal pathology [fr

  2. Cardiovascular Collapse Associated With Irreversible Cardiomyopathy, Chronic Renal Failure, and Hypertension During Routine Dental Care

    OpenAIRE

    Thoms, Sean; Cooke, Matthew; Crawford, James

    2016-01-01

    Patients with multiple comorbid conditions visit the dental office every day, and although rare, complications from their conditions may occur during treatment. A case is presented of a 65-year-old African American woman with a history of severe cardiovascular disease, renal disease, and a reported local anesthetic allergy who experienced complete cardiovascular collapse during routine dental treatment from which she was successfully resuscitated. Treating clinicians should recognize the emer...

  3. Renal effects of low-dose dopamine during vasopressor therapy for posttraumatic intracranial hypertension.

    Science.gov (United States)

    Benmalek, F; Behforouz, N; Benoist, J F; Lafay, M; Mimoz, O; Samii, K; Edouard, A R

    1999-04-01

    To investigate the effects of low-dose dopamine (Dop) on renal hemodynamics and function in patients with brain trauma receiving norepinephrine (NE). Prospective clinical study. Surgical intensive care unit of a university hospital. 20 stable, non-septic, mechanically ventilated, sedated patients with brain trauma and normal renal function treated with intravenous NE (0.11-0.65 microg/kg per min) to maintain an adequate cerebral perfusion pressure (> 60 mmHg). Two successive 1-h study periods with NE alone then NE + Dop (2 microg/kg per min). During each period, creatinine (Cl(CREAT)), sodium (Cl(Na)), potassium (Cl(K)), osmolar (Cl(OSM)) and free water (Cl(H2O)), clearances were measured in all the patients. Effective renal blood flow (ERBF, para-aminohippurate clearance) and glomerular filtration rate (GFR, inulin clearance) were measured in 7 of the 20 patients. Dop during NE infusion induced increases in urine flow and natriuresis which were not correlated with possible changes in arterial pressure. Cl(CREAT), GFR and their difference remained unchanged, whereas ERBF tended to increase. Fractional sodium excretion [100 x (Cl(Na)/Cl(CREAT)] and C1(K) increased during Dop infusion. The mechanism of Dop-induced natriuresis during NE infusion in brain trauma patients seems mainly related to a direct tubular effect of the drug.

  4. [Expression and role of soluble epoxide hydrolase in renal tissue of two kidneys one clip hypertension rats model].

    Science.gov (United States)

    Pan, Yue-juan; Tao, Zhong-fei; Wang, Qian; Lu, Min; Guan, You-fei; Zhu, Yi; Wang, Yue

    2011-12-18

    To investigate renal expression of soluble epoxide hydrolase (sEH) in 2-kidney-1-clip rats and explore the role of sEH in renal arterial stenosis hypertensive development. Hypertensive models were established in Sprague-Dawly rats by chronic partial occlusion of left renal artery. In the study,16 male Sprague-Dawly rats were randomized into sham operation group and 2-kidney-1-lip (2K1C) group (n=8, each group), and were observed for 40 days. Before operation and every ten days after operation, systolic blood pressure (SBP) was measured and twenty-four-hour urine was collected. At the end of the observation, the blood and kidneys were harvested. The serum Na,24-hour urine protein excretion were measured. Renin activity and angiotensin II concentrition in plasm and renal tissue were evaluated by radioimmunoassay (RIA).The expression of sEH, peroxisome proliferator-activated receptor-γ (PPARγ) in kidneys were assessed by immunohistochemistry and Western blotting. Histology was analysed after kidney sections were stained by Grocott-Gomori methenamine-silver nitrate. After surgery, the systolic blood pressure in 2K1C group gradually became higher than that in sham group. Urine protein excretion was statistically increased in 2K1C group on the 30 th and 40 th days, while serum sodium was of no significant difference from those of the two groups. Renin-angiotensin system in both clipped and nonclipped kidneys were also invoked by the 2K1C surgery. Both sEH and PPARγ were upregulated in renocortex and renomedulla in 2K1C group. The two groups were compared: in SBP,on the 10 th day, (106.70±7.71) vs.(124.04±6.79) mmHg, P150.40±11.76) mmHg, PUrine protein excretion,on the 30 th day,(206.81±37.61)vs.(292.33±20.53)mg/d, P=0.005; Serum sodium, (179.76±29.20) vs. (157.72±51.00)mmol/L, P=0.44; Renin activity[plasm(50.00±13.66) vs.(132.90± 31.22)ng/(L×h),P=0.03; clipped kidney(128.40±36.88)vs.(324.90±56.66)ng/(g×h), P=0.01; nonclipped kidney(103.00±19.87)vs.(345

  5. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  6. Renal function in patients with hypertension associated congestive cardiac failure seen in a tertiary hospital.

    Science.gov (United States)

    Osuji, C U; Nwaneli, C U; Onwubere, B J; Onwubuya, E I; Ahaneku, G I

    2012-01-01

    Background. Chronic kidney disease is frequently seen in patients with congestive cardiac failure and is an independent risk factor for morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease in patients with hypertension associated congestive cardiac failure. Method. One hundred and fifty patients with hypertension associated congestive cardiac failure were recruited consecutively from the medical outpatient department and the medical wards of the Nnamdi Azikiwe University Teaching Hospital Nnewi over a one year period, January to December 2010. Patients' biodata and medical history were obtained, detailed physical examination done and each patient had a chest X-ray, 12 lead ECG, urinalysis, serum urea and creatinine assay done. Ethical clearance was obtained from the Ethical Review Board of our institution and data analysed using SPSS-version 16. Results. There were 86 males and 64 females with mean age 62.7 ± 12.5 years. The mean blood pressures were systolic 152.8 ± 28.5 mmHg and diastolic 94.3 ± 18 mmHg. 84.7% had blood pressure ≥140/90 mmHg on presentation. The mean GFR was 70.1 ± 31.3 mls/min. 76% of subjects had GFR <90 mls/min and no statistical significant difference between males and females, P = 0.344. The mean serum urea was 7.2 ± 51 mmol/L while the mean serum creatinine was 194 ± 416.2 mmol/L. Conclusions. This study has demonstrated that majority of patients presenting with hypertension associated congestive cardiac failure have some degree of chronic kidney disease.

  7. Moderate (20%) fructose-enriched diet stimulates salt-sensitive hypertension with increased salt retention and decreased renal nitric oxide.

    Science.gov (United States)

    Gordish, Kevin L; Kassem, Kamal M; Ortiz, Pablo A; Beierwaltes, William H

    2017-04-01

    Previously, we reported that 20% fructose diet causes salt-sensitive hypertension. In this study, we hypothesized that a high salt diet supplemented with 20% fructose (in drinking water) stimulates salt-sensitive hypertension by increasing salt retention through decreasing renal nitric oxide. Rats in metabolic cages consumed normal rat chow for 5 days (baseline), then either: (1) normal salt for 2 weeks, (2) 20% fructose in drinking water for 2 weeks, (3) 20% fructose for 1 week, then fructose + high salt (4% NaCl) for 1 week, (4) normal chow for 1 week, then high salt for 1 week, (5) 20% glucose for 1 week, then glucose + high salt for 1 week. Blood pressure, sodium excretion, and cumulative sodium balance were measured. Systolic blood pressure was unchanged by 20% fructose or high salt diet. 20% fructose + high salt increased systolic blood pressure from 125 ± 1 to 140 ± 2 mmHg ( P  salt than either high salt, or glucose + high salt (114.2 ± 4.4 vs. 103.6 ± 2.2 and 98.6 ± 5.6 mEq/Day19; P  salt group compared to high salt only: 5.33 ± 0.21 versus 7.67 ± 0.31 mmol/24 h; P  salt-fed rats, but reduced by 40% in the 20% fructose + high salt group (2139 ± 178  μ mol /24 hrs P  salt-sensitivity and, combined with a high salt diet, leads to sodium retention, increased blood pressure, and impaired renal nitric oxide availability. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  8. Effect of Cydonia oblonga Mill. leaf extracts or captopril on blood pressure and related biomarkers in renal hypertensive rats.

    Science.gov (United States)

    Zhou, Wen-ting; Abdurahman, Adil; Abdusalam, Elzira; Yiming, Wuliya; Abliz, Parida; Aji, Qimangul; Issak, Mehray; Iskandar, Guldiyar; Moore, Nicholas; Umar, Anwar

    2014-05-14

    Cydonia oblonga Mill. (COM) is used in traditional Uyghur medicine to treat or prevent cardiovascular disease. In a previous study COM leaf extracts were found to be active in renal hypertensive rats (RHR). The present study tests the dose-dependence of the effect of ethanol leaf extracts on hypertension and on biomarkers associated with blood pressure control, such as angiotensin-II (AII), plasma renin activity (PRA), apelin-12 (A), endothelin (ET) and nitric oxide (NO), compared to captopril. Two-kidney one-clip (2K1C) Goldblatt model rats were divided randomly into six groups: sham, model, captopril 25 mg/kg, COM leaf extract 80, 160 and 320 mg/kg (n=10 each). Drugs were administered orally daily for eight weeks. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before treatment and every 2 weeks. Blood and kidney samples were collected after the last treatment to measure AII, PRA, A, ET and NO. RHR had increased blood pressure, AII, A, PRA, ET and decreased NO. Treatment with captopril reduced blood pressure, AII, A, PRA, and ET, though not quite to normal values. COM leaf extracts significantly and dose-dependently reduced blood pressure, AII, A, RA and ET, whereas NO was increased. The highest dose of COM had the same effects as captopril. The effects of COM extracts on blood pressure and biomarkers were dose-dependent and at the highest dose similar to those of captopril. This suggests an action of COM on the renin-angiotensin system, which could explain its antihypertensive effect. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. [Effects of intravenously infused magnesium on renal calcium metabolism and plasma parathyroid hormone in patients with essential hypertension].

    Science.gov (United States)

    Satoh, N; Kikuchi, K; Komura, H; Suzuki, S; Ohtomo, T; Takada, T; Nanba, M; Marusaki, S; Iimura, O

    1992-06-01

    This study aimed to elucidate the effects of intravenously infused magnesium on renal calcium and sodium metabolism in patients with essential hypertension. Mean arterial pressure (MAP), heart rate (HR), urine volume (UV), endogenous creatinine clearance (Ccr), urinary excretion of calcium (UCaV) and sodium (UNaV), fractional excretion of calcium (FECa) and sodium (FENa), plasma ionized calcium (pCa2+) and parathyroid hormone(PTH) were measured before and after intravenous infusion of 10% magnesium sulfate (initial dose: Mg 13.5mg/m2.BSA/15 min.: maintenance dose: Mg 2.7mg/m2.BSA/105min) in 6 normotensive subjects (NT) and 13 mild-to-moderate essential hypertensives (EHT). After the magnesium infusion, significant increases of UV, UCaV, UNaV, FECa and FENa, and a significant decrease of PTH were observed in both NT and EHT while MAP and HR did not change in either group. PCa2+ significantly decreased and Ccr tended to increase only in EHT. Although no significant difference was found in the change in Ccr (delta Ccr) or PTH (delta PTH) between NT and EHT, the changes of UCaV (delta UCaV), UNaV (delta UNaV), FECa (delta FECa) and FENa (delta FENa) were greater in EHT than each in NT. A positive correlation was found between delta UCaV and delta FECa, as well as delta UCaV and delta Ccr, but the former was more remarkable in both groups. In addition, delta UCaV was positively correlated with delta FENa in EHT, but not in NT. No significant relationship was observed between delta UCaV and delta PTH in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Renal proximal tubular reabsorption is reduced in adult spontaneously hypertensive rats: roles of superoxide and Na+/H+ exchanger 3.

    Science.gov (United States)

    Panico, Carolina; Luo, Zaiming; Damiano, Sara; Artigiano, Francesca; Gill, Pritmohinder; Welch, William J

    2009-12-01

    Proximal tubule reabsorption is regulated by systemic and intrinsic mechanisms, including locally produced autocoids. Superoxide, produced by NADPH oxidase enhances NaCl transport in the loop of Henle and the collecting duct, but its role in the proximal tubule is unclear. We measured proximal tubule fluid reabsorption (Jv) in WKY rats and compared that with Jv in the spontaneously hypertensive rat (SHR), a model of enhanced renal superoxide generation. Rats were treated with the NADPH oxidase inhibitor apocynin (Apo) or with small interfering RNA for p22(phox), which is the critical subunit of NADPH oxidase. Jv was lower in SHR compared with Wistar-Kyoto rats (WKY; WKY: 2.3+/-0.3 vs SHR: 1.1+/-0.2 nL/min per millimeter; n=9 to 11; P<0.001). Apo and small interfering RNA to p22(phox) normalized Jv in SHRs but had no effect in WKY rats. Jv was reduced in proximal tubules perfused with S-1611, a highly selective inhibitor of the Na(+)/H(+) exchanger 3, the major Na(+) uptake pathway in the proximal tubule, in WKY rats but not in SHRs. Pretreatment with Apo restored an effect of S-1611 to reduce Jv in the SHRs (SHR+Apo: 2.9+/-0.4 vs SHR+Apo+S-1611: 1.0+/-0.3 nL/min per millimeter; P<0.001). However, because expression of the Na(+)/H(+) exchanger 3 was similar between SHR and WKY rats, this suggests that superoxide affects Na(+)/H(+) exchanger 3 activity. Direct microperfusion of Tempol or Apo into the proximal tubule also restored Jv in SHRs. In conclusion, superoxide generated by NADPH oxidase inhibits proximal tubule fluid reabsorption in SHRs. This finding implies that proximal tubule fluid reabsorption is regulated by redox balance, which may have profound effects on ion and fluid homeostasis in the hypertensive kidney.

  11. Effects of telmisartan and olmesartan on insulin sensitivity and renal function in spontaneously hypertensive rats fed a high fat diet

    Directory of Open Access Journals (Sweden)

    Hayato Yanagihara

    2016-07-01

    Full Text Available Although telmisartan, an angiotensin II receptor blocker (ARB, has an agonistic action for proliferator-activated receptor (PPAR-γ in vitro, it remains to be determined whether telmisartan exerts such an action in vivo using a non-toxic dose (<5 mg/kg in rats. To address the issue, telmisartan (2 mg/kg and olmesartan (2 mg/kg, another ARB without PPAR-γ agonistic action, were given to spontaneously hypertensive rats (SHR fed a high fat diet (HFD. HFD decreased plasma adiponectin, and caused insulin resistance, hypertriglyceridemia and renal damage, which were improved by ARBs. Protective effects of telmisartan and olmesartan did not significantly differ. In addition, in vitro study showed that 1 μM of telmisartan did not elevate the mRNA expression of adipose protein 2, which is a PPAR-γ-stimulated adipogenic marker gene, in preadipocytes with 3% albumin. To obtain 1 μM of plasma concentration, oral dose of telmisartan was calculated to be 6 mg/kg, which indicates that PPAR-γ agonistic action is negligible with a non-toxic dose of telmisartan (<5 mg/kg in rats. This study showed that 2 mg/kg of telmisartan and olmesartan ameliorated insulin resistance, hypertriglyceridemia and renal damage in SHR fed a HFD. As beneficial effects of telmisartan and olmesartan did not significantly differ, these were mediated through the PPAR-γ-independent actions.

  12. Effect of Danshen injection on the vascular endothelial function and renal function in patients with pregnancy induced hypertension syndrome

    Directory of Open Access Journals (Sweden)

    Jun-Qing Zhang

    2016-12-01

    Full Text Available Objective: To explore the effect of Danshen injection on the vascular endothelial function and renal function in patients with pregnancy induced hypertension syndrome (PIH. Methods: A total of 100 patients with PIH who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and randomized into the observation group and the control group. The patients in the control group were given blood pressure reduction, diuresis, spasmolysis, sedation, magnesium sulfate, and comprehensive nursing intervention. On this basis, the patients in the observation group were given additional Danshen injection (20 mL + 5% glucose (250 mL, ivdrip, 1 time/d. After 10 d treatment, the efficacy was evaluated. The peripheral venous blood before and after treatment in the two groups was collected. The radioimmunoassay was used to detect ET-1. ELISA was used to detect Hcy. The immunoturbidimetry was used to detect vWF. The radioimmunoassay was used to detect BUN, Scr, UA, and β2-MG. The standard sphygmomanometer was used to monitor the blood pressure and MAP was calculated. The biuret colorimetry was used to determine 24 h Upro. Results: The reduced degree of ET-1, Hcy, and vWF after treatment in the observation group was significantly superior to that in the control group. The reduced degree of BUN, Scr, UA, and β2-MG after treatment in the observation group was significantly superior to that in the control group. The reduced degree of MPA and 24 h Upro after treatment in the observation group was significantly superior to that in the control group. Conclusions: Routine treatments, comprehensive nursing intervention, and Danshen injection in the treatment of PIH can effectively improve the vascular endothelial function and renal function in order to reduce the blood pressure and alleviate the urine protein.

  13. VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect) spectrum presenting with portal hypertension: a case report.

    Science.gov (United States)

    Bhurtel, Dilli Raj; Losa, Ignatius

    2010-05-05

    We report for the first time a unique case of VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect) spectrum associated with portal hypertension. The occurrence of both VACTERL spectrum and extrahepatic portal hypertension in a patient has not been reported in the literature. We examined whether or not there was any association between extrahepatic portal hypertension and VACTERL spectrum. A two-and-half-year-old Caucasian girl with VACTERL spectrum presented with hematemesis and abdominal distension. She had caput medusae, ascites, splenomegaly, gastric and esophageal varices. Her liver function tests were within normal limits. Magnetic resonance imaging of the liver with contrast showed a thready portal vein with collateral vessels involving both right and left portal veins without intrahepatic duct dilation. A thready portal vein, with features of extrahepatic portal hypertension, is a rare non- VACTERL-type defect in patients with VACTERL spectrum. Understandably, clinicians should give low priority to looking for portal hypertension in VACTERL spectrum patients presenting with gastrointestinal bleeding. However before routinely looking for a thready portal vein and/or extrahepatic portal hypertension in asymptomatic VACTERL spectrum patients, we need further evidence to support this rare association.

  14. Hemodynamic and neural responses to renal denervation of the nerve to the clipped kidney by cryoablation in two-kidney, one-clip hypertensive rats.

    Science.gov (United States)

    Rossi, Noreen F; Pajewski, Russell; Chen, Haiping; Littrup, Peter J; Maliszewska-Scislo, Maria

    2016-01-15

    Renal artery stenosis is increasing in prevalence. Angioplasty plus stenting has not proven to be better than medical management. There has been a reluctance to use available denervation methodologies in this condition. We studied conscious, chronically instrumented, two-kidney, one-clip (2K-1C) Goldblatt rats, a model of renovascular hypertension, to test the hypothesis that renal denervation by cryoablation (cryo-DNX) of the renal nerve to the clipped kidney decreases mean arterial pressure (MAP), plasma and tissue ANG II, and contralateral renal sympathetic nerve activity (RSNA). Five-week-old male Sprague-Dawley rats underwent sham (ShC) or right renal artery clipping (2K-1C), placement of telemetry transmitters, and pair-feeding with a 0.4% NaCl diet. After 6 wk, rats were randomly assigned to cryo-DNX or sham cryotreatment (sham DNX) of the renal nerve to the clipped kidney. MAP was elevated in 2K-1C and decreased significantly in both ShC cryo-DNX and 2K-1C cryo-DNX. Tissue norepinephrine was ∼85% lower in cryo-DNX kidneys. Plasma ANG II was higher in 2K-1C sham DNX but not in 2K-1C cryo-DNX vs ShC. Renal tissue ANG II in the clipped kidney decreased after cryo-DNX. Baseline integrated RSNA of the unclipped kidney was threefold higher in 2K-1C versus ShC and decreased in 2K-1C cryo-DNX to values similar to ShC. Maximum reflex response of RSNA to baroreceptor unloading in 2K-1C was lower after cryo-DNX. Thus, denervation by cryoablation of the renal nerve to the clipped kidney decreases not only MAP but also plasma and renal tissue ANG II levels and RSNA to the contralateral kidney in conscious, freely moving 2K-1C rats.

  15. WE-E-BRE-02: BEST IN PHYSICS (THERAPY) - Stereotactic Radiotherapy for Renal Sympathetic Ablation for the Treatment of Refractory Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Maxim, P; Wheeler, M; Loo, B [Stanford University, Stanford, CA (United States); Maguire, P [Cyberheart, Inc., Sunnyvale, CA (United States)

    2014-06-15

    Purpose: To determine the safety and efficacy of stereotactic radiotherapy as a novel treatment for patients with refractory hypertension in a swine model. Uncontrolled hypertension is a significant contributor to morbidity and mortality, substantially increasing the risk of ischemic stroke, ischemic heart disease, and kidney failure. Methods: High-resolution computed tomography (CT) images of anesthetized pigs were acquired and treatment plans for each renal artery and nerve were developed using our clinically implemented treatment planning system. Stereotactic radiotherapy, 40Gy in single fraction was delivered bilaterally to the renal nerves using a state-of-the-art medical linear accelerator under image guidance utilizing dynamic conformal arcs. Dose to nearby critical organs was evaluated by dosevolume histogram analysis and correlated to toxicity data obtained through follow up pathology analysis. The animals were observed for six months with serial measurements of blood pressure, urine analysis, serum laboratories, and overall clinical and behavioral status. Results: All animals survived to the follow-up point without evidence of renal dysfunction (stable serum creatinine), skin changes, or behavioral changes that might suggest animal discomfort. Plasma norepinephrine levels (ng/ml) were followed monthly for 6 months. The average reduction observed was 63%, with the median reduction at 73.5%. Microscopic evaluation 4–6 weeks after treatment showed evidence of damage to the nerves around treated renal arteries. Considerable attenuation in pan neurofilament expression by immunohistochemistry was observed with some vacuolar changes indicative of injury. There was no histological or immunohistochemical evidence of damage to nearby spinal cord or spinal nerve root structures. Conclusion: Our preclinical studies have shown stereotactic radiotherapy to the renal sympathetic plexus to be safe and effective in reducing blood pressure, thus this approach holds great

  16. Effect of hypertension at presentation on prognosis in patients with dilated cardiomyopathy presenting with normal renal angiogram

    Directory of Open Access Journals (Sweden)

    Swetha Balije

    2016-01-01

    Full Text Available Background & objectives: Dilated cardiomyopathy (DCM is a progressive disease of heart with systolic and diastolic dysfunction carrying a poor long-term prognosis. The prognostic index and predictors of mortality are considered to be useful in guiding the treatment. This study was undertaken to evaluate the effects of hypertension at presentation on prognosis in patients with DCM presenting with normal renal and coronary angiogram. Methods: An observational, analytical, non-interventional and a combination of retrospective and prospective study was conducted in patients between 15 and 75 yr of age with DCM having on and off symptoms while receiving treatment in a cardiology outpatient department for more than a year. Sixty patients who fulfilled the inclusion criteria were enrolled in the study. Left ventricular systolic and diastolic functions were assessed by echocardiography along with New York Heart Association (NYHA functional class prospectively and at baseline retrospectively. Patients were grouped into two categories: DCM with hypertension at presentation (HTNAP, Category 1 and DCM without hypertension at presentation (NHTNAP, Category 2. The primary end-points were the number and dose of parenteral drugs at hospitalization, duration of hospital stay and change in the left ventricular (LV systolic function expressed as LV ejection fraction, and the secondary end-points included overall mortality, change in LV and right ventricular systolic and diastolic functions and change in the NYHA functional class between baseline and three month follow up in patients. Results: Thirty five and 25 patients presented with HTNAP and NHTNAP, respectively (total 60. The overall mortality was 10 per cent (6/60. The number of hospitalizations was less in HTNAP category and of days of hospital stay was 6.3 in HTNAP and 9.8 in NHTNAP, the difference being significant (P < 0.001. The HTNAP category required less parenteral diuretics and inotropes compared

  17. Impact of achieved blood pressure on renal function decline and first stroke in hypertensive patients with chronic kidney disease.

    Science.gov (United States)

    Li, Youbao; Liang, Min; Jiang, Chongfei; Wang, Guobao; Li, Jianping; Zhang, Yan; Fan, Fangfang; Sun, Ningling; Cui, Yiming; He, Mingli; Tang, Genfu; Yin, Delu; Cheng, Xiaoshu; Wang, Binyan; Huo, Yong; Xu, Xin; Hou, Fan Fan; Xu, Xiping; Qin, Xianhui

    2018-03-01

    The effect of achieved blood pressure (BP) on first stroke and renal function decline among hypertensive patients with mild to moderate chronic kidney disease (CKD) is still uncertain. In total, 3230 hypertensive patients with estimated glomerular filtration rate 30-60 mL/min/1.73 m2 and/or proteinuria were included in the present analyses. Eligible participants were randomly assigned to a daily treatment of a combined enalapril 10 mg and folic acid 0.8 mg tablet or an enalapril 10 mg tablet alone. Participants were followed up every 3 months. The study outcomes included first stroke and the progression of CKD. The median antihypertensive treatment duration was 4.7 years. Compared with participants with a time-averaged on-treatment systolic blood pressure (SBP) of 135 to ≤140 mmHg, the incidence of total first stroke [1.7% versus 3.3%; hazard ratio (HR), 0.51; 95% confidence interval (CI): 0.26-0.99] and ischemic stroke (1.3% versus 2.8%; HR, 0.46; 95% CI: 0.22-0.98) decreased significantly in those with a time-averaged SBP of ≤135 mmHg. Furthermore, a time-averaged diastolic blood pressure (DBP) of ≤80 mmHg, compared with a time-averaged DBP level of 80 to ≤90 mmHg, was significantly related to a decreased risk of hemorrhagic stroke (0.2% versus 0.9%; HR, 0.18; 95% CI: 0.04-0.80). However, compared with participants with a time-averaged SBP of 135 to ≤140 mmHg, a lower but non-significant trend of CKD progression was found in those with a time-averaged SBP of ≤130 mmHg. A BP treatment level of ≤135/80 mmHg, compared with a BP treatment level of 135-140/80-90 mmHg, could lead to a decreased risk of first stroke in hypertensive patients with mild-to-moderate CKD. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Effects of sodium nitrite on renal function and blood pressure in hypertensive vs. healthy study participants

    DEFF Research Database (Denmark)

    Rosenbæk, Jeppe B; Hornstrup, Bodil G; Jørgensen, Andreas N

    2018-01-01

    to determine the effects of NaNO2 on blood pressure (BP) and renal sodium and water regulation in patients with EHT compared with healthy control study participants (CON). METHODS: In a placebo-controlled, crossover study, we infused 240 μg NaNO2/kg/h or isotonic saline for 2 h in 14 EHT and 14 CON. During...... infusion, we measured changes in brachial and central BP, free water clearance, fractional sodium excretion, and urinary excretion rate of γ-subunit of the epithelial sodium channel (U-ENaCγ), and aquaporin-2 (U-AQP2). RESULTS: Placebo-adjusted brachial SBP decreased 18 mmHg (P ... infusion in EHT and 12 mmHg (P fractional sodium excretion, free water clearance, and U...

  19. Resistant Hypertension.

    Science.gov (United States)

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

  20. Carbonic Anhydrases III and IV Autoantibodies in Rheumatoid Arthritis, Systemic Lupus Erythematosus, Diabetes, Hypertensive Renal Disease, and Heart Failure

    Directory of Open Access Journals (Sweden)

    Chengeng Liu

    2012-01-01

    Full Text Available In the present study, the CA III and IV autoantibodies, CA activity, antioxidant enzymes and cytokines in rheumatoid arthritis (RA, systemic lupus erythematosus (SLE, diabetes, hypertensive renal disease, and heart failure were investigated. The anti-CA III antibody titers in patients with RA, SLE, and type 1 diabetes (T1D were significantly higher than that in control groups (P<0.05. The anti-CA IV antibody titers in patients with RA, SLE, type 1 diabetic nephropathy (T1DN, and heart failure were significantly higher than that in control groups (P<0.05 while anti-CA IV antibody could suppress the total CA activity. The SOD and GPx levels in patients with RA, SLE, and T1DN were significantly lower than that in control groups (P<0.05. IL-6, IL-17, IFN-γ, and TNF-α levels were significantly higher in SLE group compared with the control group (P<0.05. Weak but significant correlations were found between anti-CA III antibodies and ESR in RA (r=0.403, P=0.013 and SLE patients (r=0.397, P=0.007. These results suggested that the generation of CA III and IV autoantibodies, antioxidant enzymes, and cytokines might influence each other and CA autoantibodies might affect the normal physiology function of CA.

  1. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  2. Angiotensin-(1-9) reverses experimental hypertension and cardiovascular damage by inhibition of the angiotensin converting enzyme/Ang II axis.

    Science.gov (United States)

    Ocaranza, Maria Paz; Moya, Jackeline; Barrientos, Victor; Alzamora, Rodrigo; Hevia, Daniel; Morales, Cristobal; Pinto, Melissa; Escudero, Nicolás; García, Lorena; Novoa, Ulises; Ayala, Pedro; Díaz-Araya, Guillermo; Godoy, Ivan; Chiong, Mario; Lavandero, Sergio; Jalil, Jorge E; Michea, Luis

    2014-04-01

    Little is known about the biological effects of angiotensin-(1-9), but available evidence shows that angiotensin-(1-9) has beneficial effects in preventing/ameliorating cardiovascular remodeling. In this study, we evaluated whether angiotensin-(1-9) decreases hypertension and reverses experimental cardiovascular damage in the rat. Angiotensin-(1-9) (600  ng/kg per min for 2 weeks) reduced already-established hypertension in rats with early high blood pressure induced by angiotensin II infusion or renal artery clipping. Angiotensin-(1-9) also improved cardiac (assessed by echocardiography) and endothelial function in small-diameter mesenteric arteries, cardiac and aortic wall hypertrophy, fibrosis, oxidative stress, collagen and transforming growth factor type β - 1 protein expression (assessed by western blot). The beneficial effect of angiotensin-(1-9) was blunted by coadministration of the angiotensin type 2(AT2) receptor blocker PD123319 (36  ng/kg per min) but not by coadministration of the Mas receptor blocker A779 (100  ng/kg per min). Angiotensin-(1-9) treatment also decreased circulating levels of Ang II, angiotensin-converting enzyme activity and oxidative stress in aorta and left ventricle. Whereas, Ang-(1-9) increased endothelial nitric oxide synthase mRNA levels in aorta as well as plasma nitrate levels. Angiotensin-(1-9) reduces hypertension, ameliorates structural alterations (hypertrophy and fibrosis), oxidative stress in the heart and aorta and improves cardiac and endothelial function in hypertensive rats. These effects were mediated by the AT2 receptor but not by the angiotensin-(1-7)/Mas receptor axis.

  3. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling Bjerregaard; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  4. Renal intramedullary infusion of tempol normalizes the blood pressure response to intrarenal blockade of heme oxygenase-1 in angiotensin II-dependent hypertension.

    Science.gov (United States)

    Stec, David E; Juncos, Luis A; Granger, Joey P

    2016-04-01

    Previous studies have demonstrated that intramedullary inhibition of heme oxygenase-1 (HO-1) increases the blood pressure and superoxide production response to angiotensin II (Ang II) infusion. The present study was designed to test the hypothesis that increased renal medullary superoxide production contributes to the increase in blood pressure in response to blockade of renal medullary HO-1 in Ang II-induced hypertension. Male C57BL/6J mice (16-24 weeks of age) were implanted with chronic intrarenal medullary interstitial (IRMI) and infused with: saline, tempol (6 mM), the HO-1 inhibitor QC-13 (25 μM), or a combination of tempol + QC-13. Tempol treatment was started 2 days before infusion of QC-13. After 2 days, Ang II was infused subcutaneously at a rate of 1 μg/kg/min for 10 days. Blood pressures on days 7-10 of Ang II infusion alone averaged 150 ± 3 mm Hg in mice receiving IRMI infusion of saline. IRMI infusion of QC-13 increased blood pressure in Ang II-treated mice to 164 ± 2 (P tempol had a blood pressure of 136 ± 3 mm Hg. Ang II-treated mice receiving IRMI infusion of tempol and QC-13 had a significantly lower blood pressure (142 ± 2 mm Hg, P tempol alone or in combination with QC-13. These results demonstrate that renal medullary interstitial blockade of HO-1 exacerbates Ang II-induced hypertension via a mechanism that is dependent on enhanced superoxide generation and highlight the important antioxidant function of HO-1 in the renal medulla. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  5. Worse renal disease in postmenopausal F2[Dahl S x R]-intercross rats: detection of novel QTLs affecting hypertensive kidney disease.

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    Victoria L M Herrera

    Full Text Available The prevalence of hypertension increases after menopause with 75% of postmenopausal women developing hypertension in the United States, along with hypertensive end organ diseases. While human and animal model studies have indicated a protective role for estrogen against cardiovascular disease and glomerulosclerosis, clinical studies of hormone replacement therapy in postmenopausal women have shown polar results with some improvement in hypertension but worsening of hypertensive kidney disease, or no effect at all. These observations suggest that the pathogenesis of postmenopausal hypertension and its target organ complications is more complex than projected, and that loss of endogenous estrogens induces epigenetic changes that alter genetic susceptibility to end-organ complications per se resulting in pathogenetic mechanisms beyond correction by hormone replacement. We studied postmenopausal-induced changes in renal disease and performed a total genome scan for quantitative trait loci (QTLs affecting kidney disease in postmenopausal 16m-old F2[Dahl S x R]-intercross female rats. We used glomerular injury score (GIS as quantitative trait. We compared QTLs amongst premenopausal, ovariectomized and postmenopausal F2[Dahl S x R]-intercross rats using identical phenotype characterization. Postmenopausal F2[Dahl S x R]-intercross rats exhibited increased hypertensive glomerulosclerosis (P<0.01 and equivalent levels of kidney disease when compared to premenopausal and ovariectomized F2[Dahl S x R]-intercross rats respectively. We detected three significant to highly significant GIS-QTLs (GIS-pm1 on chromosome 4, LOD 3.54; GIS-pm2 on chromosome 3, LOD 2.72; GIS-pm3 on chromosome 5, LOD 2.37 and two suggestive GIS-QTLs (GIS-pm4 on chromosome 2, LOD 1.70; GIS-pm5 on chromosome 7, LOD 1.28, all of which were unique to this postmenopausal population. Detection of increased renal disease phenotype in postmenopausal and ovariectomized subjects suggests a

  6. Rapid renal alpha-1 antitrypsin gene induction in experimental and clinical acute kidney injury.

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    Richard A Zager

    Full Text Available Alpha-1-antitrypsin (AAT is a hepatic stress protein with protease inhibitor activity. Recent evidence indicates that ischemic or toxic injury can evoke selective changes within kidney that resemble a hepatic phenotype. Hence, we tested the following: i Does acute kidney injury (AKI up-regulate the normally renal silent AAT gene? ii Does rapid urinary AAT excretion result? And iii Can AAT's anti-protease/anti-neutrophil elastase (NE activity protect injured proximal tubule cells? CD-1 mice were subjected to ischemic or nephrotoxic (glycerol, maleate, cisplatin AKI. Renal functional and biochemical assessments were made 4-72 hrs later. Rapidly following injury, 5-10 fold renal cortical and isolated proximal tubule AAT mRNA and protein increases occurred. These were paralleled by rapid (>100 fold increases in urinary AAT excretion. AKI also induced marked increases in renal cortical/isolated proximal tubule NE mRNA. However, sharp NE protein levels declines resulted, which strikingly correlated (r, -0.94 with rising AAT protein levels (reflecting NE complexing by AAT/destruction. NE addition to HK-2 cells evoked ∼95% cell death. AAT completely blocked this NE toxicity, as well as Fe induced oxidant HK-2 cell attack. Translational relevance of experimental AAT gene induction was indicated by ∼100-1000 fold urinary AAT increases in 22 AKI patients (matching urine NGAL increases. We conclude: i AKI rapidly up-regulates the renal cortical/proximal tubule AAT gene; ii NE gene induction also results; iii AAT can confer cytoprotection, potentially by blocking/reducing cytotoxic NE accumulation; and iv marked increases in urinary AAT excretion in AKI patients implies clinical relevance of the AKI- AAT induction pathway.

  7. Três casos de hipertensão e Fístula Arteriovenosa Renal: com uma fístula de novo Tres casos de hipertención y Fístula Arteriovenosa Renal: con una fístula de novo Three cases of hypertension and Renal Arteriovenous fistula with a de novo fistula

    Directory of Open Access Journals (Sweden)

    Natalia Correa Vieira Melo

    2009-05-01

    Full Text Available Fístula Arteriovenosa Renal (FAVR é uma causa rara e potencialmente reversível de hipertensão e insuficiência renal e/ou cardíaca. O tratamento da FAVR visa preservar o máximo de parênquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serão relatados três casos de FAVR, incluindo um caso de FAVR idiopática de novo, que se apresentaram com hipertensão e insuficiência renal e/ou cardíaca, e descrever a terapêutica adotada e os resultados obtidos.La Fístula Arteriovenosa Renal (FAVR es una causa rara y potencialmente reversible de hipertensión e insuficiencia renal y/o cardíaca. El tratamiento de la FAVR busca preservar el máximo de parénquima renal y, concomitantemente, erradicar los síntomas y efectos hemodinámicos resultantes de la FAVR. En el presente estudio, se relatarán tres casos de FAVR, incluyendo un caso de FAVR idiopática de novo, que se presentaron con hipertensión e insuficiencia renal y/o cardíaca, y describir la terapéutica adoptada y los resultados obtenidos.The Renal Arteriovenous Fistula (RAVF is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

  8. An Alternative Hypothesis to the Widely Held View That Renal Excretion of Sodium Accounts for Resistance to Salt-Induced Hypertension

    Science.gov (United States)

    Kurtz, Theodore W.; DiCarlo, Stephen E.; Pravenec, Michal; Schmidlin, Olga; Tanaka, Masae; Morris, R. Curtis

    2016-01-01

    It is widely held that in response to high salt diets, normal individuals are acutely and chronically resistant to salt-induced hypertension because they rapidly excrete salt and retain little of it so that their blood volume, and therefore blood pressure, does not increase. Conversely, it is also widely held that salt-sensitive individuals develop salt-induced hypertension because of an impaired renal capacity to excrete salt that causes greater salt retention and blood volume expansion than that which occurs in normal salt-resistant individuals. Here we review results of both acute and chronic salt-loading studies that have compared salt-induced changes in sodium retention and blood volume between normal subjects (salt-resistant normotensive controls) and salt-sensitive subjects. The results of properly controlled studies strongly support an alternative view: during acute or chronic increases in salt intake, normal salt-resistant subjects undergo substantial salt retention and do not excrete salt more rapidly, retain less sodium, or undergo lesser blood volume expansion than do salt-sensitive subjects. These observations: 1) directly conflict with the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension, and 2) have implications for contemporary understanding of how various genetic, immunologic, and other factors determine acute and chronic blood pressure responses to high salt diets. PMID:27546606

  9. An alternative hypothesis to the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension.

    Science.gov (United States)

    Kurtz, Theodore W; DiCarlo, Stephen E; Pravenec, Michal; Schmidlin, Olga; Tanaka, Masae; Morris, R Curtis

    2016-11-01

    It is widely held that in response to high salt diets, normal individuals are acutely and chronically resistant to salt-induced hypertension because they rapidly excrete salt and retain little of it so that their blood volume, and therefore blood pressure, does not increase. Conversely, it is also widely held that salt-sensitive individuals develop salt-induced hypertension because of an impaired renal capacity to excrete salt that causes greater salt retention and blood volume expansion than that which occurs in normal salt-resistant individuals. Here we review results of both acute and chronic salt-loading studies that have compared salt-induced changes in sodium retention and blood volume between normal subjects (salt-resistant normotensive control subjects) and salt-sensitive subjects. The results of properly controlled studies strongly support an alternative view: during acute or chronic increases in salt intake, normal salt-resistant subjects undergo substantial salt retention and do not excrete salt more rapidly, retain less sodium, or undergo lesser blood volume expansion than do salt-sensitive subjects. These observations: (i) directly conflict with the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension, and (ii) have implications for contemporary understanding of how various genetic, immunologic, and other factors determine acute and chronic blood pressure responses to high salt diets. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  10. Renovascular hypertension

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

    1989-01-01

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  11. Infusion of Valproic Acid Into the Renal Medulla Activates Stem Cell Population and Attenuates Salt-Sensitive Hypertension in Dahl S Rats.

    Science.gov (United States)

    Wang, Zhengchao; Zhu, Qing; Wang, Weili; Yi, Fan; Li, Pin-Lan; Boini, Krishna M; Li, Ningjun

    2017-01-01

    Our previous study has detected a stem cell deficiency in the renal medulla in Dahl salt-sensitive (S) rats. This study determined whether infusion of valproic acid (VA), an agent known to stimulate the stem cell function, attenuated salt-sensitive hypertension in Dahl S rats. Uninephrectomized Dahl S rats were infused with vehicle or VA (50mg/kg/d) into the renal medulla and fed with a low (LS) or high salt diet (HS). Stem cell marker and number were analyzed by immunohistochemistry, Real-time RT-PCR and Western blot. Sodium excretion and blood pressure were measured. VA significantly increased the mRNA and protein levels of FGF2, a stem cell niche factor, and CD133, a stem cell marker. The number of CD133+ cells was significantly increased in the renal medulla in VA-treated rats. Meanwhile, high salt-induced increases in the mRNA level of proinflammatory factors interleukin-1β and interleukin-6 were blocked in VA-treated rats. Functionally, sodium excretion in response to the blood pressure increase and acute sodium loading was significantly enhanced, sodium retention attenuated, high salt-induced increase of blood pressure reduced in VA-treated rats. Activation of stem cell function by VA inhibits the activation of proinflammatory factors and attenuates salt-sensitive hypertension in Dahl S rats. © 2017 The Author(s). Published by S. Karger AG, Basel.

  12. Effect of Angiotensin-Converting Enzyme Inhibitor/Calcium Antagonist Combination Therapy on Renal Function in Hypertensive Patients With Chronic Kidney Disease: Chikushi Anti-Hypertension Trial - Benidipine and Perindopril.

    Science.gov (United States)

    Okuda, Tetsu; Okamura, Keisuke; Shirai, Kazuyuki; Urata, Hidenori

    2018-02-01

    Appropriate blood pressure control suppresses progression of chronic kidney disease (CKD). If an angiotensin-converting enzyme (ACE) inhibitor is ineffective, adding a calcium antagonist is recommended. We compared the long-term effect of two ACE inhibitor/calcium antagonist combinations on renal function in hypertensive patients with CKD. Patients who failed to achieve the target blood pressure (systolic/diastolic: calcium antagonist amlodipine (group A) or perindopril and the T/L type calcium antagonist benidipine (group B). The primary endpoint was the change of the estimated glomerular filtration rate (eGFR) after 2 years. Eligible patients had a systolic pressure ≥ 130 mm Hg and/or diastolic pressure ≥ 80 mm Hg and CKD (urine protein (+) or higher, eGFR calcium antagonist may prevent deterioration of renal function more effectively than an ACE inhibitor/L type calcium antagonist combination.

  13. Vibroacustic microvibrations enhance kidney blood supply, glomerular filtration and glutathione peroxidase activity in spontaneously hypertensive rats.

    Science.gov (United States)

    Miloradović, Zoran; Mihailović-Stanojević, Nevena; Jovović, Đurđica; Ivanov, Milan; Vajić, Una J; Karanović, Danijela; Grujić Milanović, Jelica

    2015-01-01

    Limited numbers of studies include research of microvibration therapy in experimental models. We examined effects of chronic vibroacustic-microvibration treatment on haemodynamics and anti-oxidative defense in experimental hypertension. Study was performed on chronically treated hypertensive and normotensive Wistar rats. Mean arterial pressure (MAP), cardiac output (CO), renal blood flow (RBF), glomerular filtration and activity of anti-oxidative enzymes were determined after three weeks treatment. Vibroacustic treatment had no influence on MAP and CO, but RBF was increased in both groups of treated rats. Additionally, vibroacustic treatment enhanced diuresis and increased glomerular filtration in hypertensive rats. Glutathione peroxidase (GSH-Px) activity was elevated in both treated rat strains, but activity of superoxide dismutase was unchanged. We conclude that microvibration treatment doesn't ameliorate hypertension but improves renal blood supply (trough diminished renal vascular resistance), glomerular filtration, diuresis, and enhances glutathione dependent anti-oxidant defense with more important beneficials in hypertensive animals.

  14. Effect of nifedipine combined with Magnesium Sulfate on oxidative stress, hemorheology, platelet active substances and renal function in patients with pregnancy-induced hypertension

    Directory of Open Access Journals (Sweden)

    Dan Liu

    2017-09-01

    Full Text Available Objective: To investigate effect of nifedipine combined with Magnesium Sulfate on levels of oxidative stress, blood rheology, platelet active substance and renal function in patients with pregnancy-induced hypertension. Methods: A total of 99 cases of patients with pregnancyinduced hypertension were selected as the study object, according to random data table, they were divided into control group (n=50 and observation group (n=49, patients in control group were treated with Magnesium Sulfate, while patients in the observation group received Magnesium Sulfate combined with nifedipine treatment, levels of blood pressure and oxidative stress, blood rheology, platelet activity and renal function index before and after treatment of both groups were compared. Results: There were no significant difference of the level of DBP, SBP, TAc, MDA, SOD, high/low shear blood viscosity, PV, HCT, CD62P, CD63, GPⅡb/Ⅲa, SCr and BUN before treatment between control group and the observation group. Compared with intragroup before treatment, the levels of DBP, SBP, MDA, high/low shear blood viscosity, PV, HCT, CD62P, CD63, GPⅡb/Ⅲa, SCr and BUN after treatment of the two groups were significantly decreased, and the levels of the observation group after treatment was significantly lower than those in the control group, the difference was statistically significant; Compared with level of SOD and TAc, after treatment, the levels of SOD and TAc of the two groups were significantly higher than those in the same group before treatment, and levels of the observation group was significantly higher than in the control group, the difference was statistically significant. Conclusion: Nifedipine combined with magnesium sulfate treatment of pregnancy-induced hypertension, which can effectively reduce the blood pressure level of patients, improve the levels of oxidative stress, blood rheology and platelet active substance, protect renal function, with an important clinical

  15. Nitric oxide levels in the aqueous humor vary in different ocular hypertension experimental models

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    Da-Wen Lu

    2014-12-01

    Full Text Available This study investigated the relationships among intraocular pressure (IOP, nitric oxide (NO levels, and aqueous flow rates in experimental ocular hypertension models. A total of 75 rabbits were used. One of four different materials [i.e., α-chymotrypsin, latex microspheres (Polybead, red blood cell ghosts, or sodium hyaluronate (Healon GV] was injected into the eyes of the 15 animals in each experimental group; the remaining 15 rabbits were reserved for a control group. The IOP changes in the five groups were recorded on postinduction Days 1–3, Day 7, Day 14, Day 30, Day 60, Day 90, and Day 120. On postinduction Day 7, the dynamics and NO levels in the aqueous humor were recorded. Significant IOP elevations were induced by α-chymotrypsin (p < 0.01 and Polybead (p < 0.01 on each postinduction day. In the red blood cell ghosts model, significant elevations (p < 0.01 were found on postinduction Days 1–3; Healon GV significantly elevated IOP (p < 0.01 on postinduction Day 1 and Day 2. On postinduction Day 7, the aqueous humor NO levels increased significantly in the models of α-chymotrypsin, Polybead, and red blood cell ghosts (all p < 0.01, while the aqueous flow rates were significantly reduced in the models of α-chymotrypsin and Polybead (p < 0.005. Persistent ocular hypertension models were induced with α-chymotrypsin and Polybead in the rabbits. The Polybead model exhibited the characteristic of an increased aqueous humor NO level, similar to human eyes with acute angle-closure glaucoma and neovascular glaucoma.

  16. Experimental and clinical substantiation of a choice of optimum methods of radiodiagnosis of renal diseases

    International Nuclear Information System (INIS)

    Telichko, F.F.; Yazykov, A.S.

    1989-01-01

    Limits of potentialities of methods of radiodiagnosis of renal diseases were studied by way of experimental simulation of organs with various pathomorphological changes (urilithiasis, kidney tumors and tuberculosis). Special attention was paid to the detection of pathomorphological elements which were characteristics for the initial form of disease. Protofilm and thermoluminiscent dosimetry were used to study radiation-hygienic characteristics of radiation metods of kidney investigation. Recommendation for establishing diagnosis were worked out in suspected urolithiasis, kidney tumors and tuberculosis. An objective method of the control over the quality of roentgenocontrast images was proposed

  17. Catalase overexpression prevents nuclear factor erythroid 2-related factor 2 stimulation of renal angiotensinogen gene expression, hypertension, and kidney injury in diabetic mice.

    Science.gov (United States)

    Abdo, Shaaban; Shi, Yixuan; Otoukesh, Abouzar; Ghosh, Anindya; Lo, Chao-Sheng; Chenier, Isabelle; Filep, Janos G; Ingelfinger, Julie R; Zhang, Shao Ling; Chan, John S D

    2014-10-01

    This study investigated the impact of catalase (Cat) overexpression in renal proximal tubule cells (RPTCs) on nuclear factor erythroid 2-related factor 2 (Nrf2) stimulation of angiotensinogen (Agt) gene expression and the development of hypertension and renal injury in diabetic Akita transgenic mice. Additionally, adult male mice were treated with the Nrf2 activator oltipraz with or without the inhibitor trigonelline. Rat RPTCs, stably transfected with plasmid containing either rat Agt or Nrf2 gene promoter, were also studied. Cat overexpression normalized systolic BP, attenuated renal injury, and inhibited RPTC Nrf2, Agt, and heme oxygenase-1 (HO-1) gene expression in Akita Cat transgenic mice compared with Akita mice. In vitro, high glucose level, hydrogen peroxide, and oltipraz stimulated Nrf2 and Agt gene expression; these changes were blocked by trigonelline, small interfering RNAs of Nrf2, antioxidants, or pharmacological inhibitors of nuclear factor-κB and p38 mitogen-activated protein kinase. The deletion of Nrf2-responsive elements in the rat Agt gene promoter abolished the stimulatory effect of oltipraz. Oltipraz administration also augmented Agt, HO-1, and Nrf2 gene expression in mouse RPTCs and was reversed by trigonelline. These data identify a novel mechanism, Nrf2-mediated stimulation of intrarenal Agt gene expression and activation of the renin-angiotensin system, by which hyperglycemia induces hypertension and renal injury in diabetic mice. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  18. Analysis of experimental evidence that shows adverse effects of salt and its relation to hypertension

    Directory of Open Access Journals (Sweden)

    Ignacio Bravo A.

    2012-02-01

    Full Text Available The study by Taylor et al published in June 2010 in the American Journal of Hypertension questions the effectiveness of reducing salt intake in the diet in the prevention and treatment of high blood pressure and other cardiovascular conditions. The publication of this article has lead to great controversy and medical associations and learned societies responded promptly. The response criticized the results of the meta-analysis and pointed out its methodological shortcomings. In this review we critically appraise the experimental evidence that shows the importance of diet salt intake and its role as a determinant of blood pressure. We briefly describe the paradigm that explains the role of salt intake in contributing in the regulation of blood pressure (Guyton hypothesis and model and we mention the experimental evidence that supports this. We briefly comment on the classical studies that indicate that salt intake (NaCl contributes directly to the development of high blood pressure and target tissues. Finally, we briefly mention the experimental data that is related with the controversy on the role of salt (NaCl or sodium as prohypertensive agents.

  19. The reproducibility of the circadian BP rhythm in treated hypertensive patients with polycystic kidney disease and mild chronic renal impairment--a prospective ABPM study.

    Science.gov (United States)

    Covic, Adrian; Mititiuc, Irina; Gusbeth-Tatomir, Paul; Goldsmith, David J

    2002-01-01

    Diurnal BP rhythm is known to be abnormal (reduced BP fall with sleep) in chronic renal failure, dialysis and renal transplantation patients. In subjects with primary hypertension and with reduced diurnal BP fall with sleep there is consistent evidence of increased target-organ damage. However, the few studies that have addressed the reproducibility of diurnal rhythm in normal or hypertensive subjects have concluded that the BP fall with sleep is poorly reproducible. It is not known whether the same is true for patients with renal disease. In 30 subjects with autosomal polycystic kidney disease (ADPKD), mild chronic renal failure and normal office BP levels on standardised anti-hypertensive treatment, ambulatory blood pressure monitoring (ABPM) was done three times over a twelve month period to assess the reproducibility of blood pressure fall with sleep. When comparing ABPM 2 with the ABPM 1 recording (3 months difference between measurements) only 43.3% of the patients maintained the initial dipping category (defined by quartiles of the ABPM 1 diurnal BP distribution). The same proportion of subjects had a similar dipping category, when ABPM 3 was compared to ABPM 1 (9 months difference between measurements), but a large (24%) subset of patients had dramatic shifts in their amplitude in nocturnal BP fall, significantly greater than those recorded after a shorter inter-measurement interval. Equally important, our study reveals the fact that, with time, there is no tendency to decrease circadian variation: a similar proportion (a quarter to one third) of patients increased or decreased their amplitude in nocturnal BP fall, at 3 and 9 months. When several ABPM measurements are repeated for the same patients, the repeatability is even worse, since only 36.6% of our study population maintained the initial dipping category across all three ABPM determinations (ABPM 1 and ABPM 2 and ABPM 3). There is a widespread abnormality in diurnal BP rhythm in ADPKD patients with

  20. Methylenetetrahydrofolate reductase (MTHFR) polymorphism A1298C (Glu429Ala) predicts decline in renal function over time in the African-American Study of Kidney Disease and Hypertension (AASK) Trial and Veterans Affairs Hypertension Cohort (VAHC).

    Science.gov (United States)

    Fung, Maple M; Salem, Rany M; Lipkowitz, Michael S; Bhatnagar, Vibha; Pandey, Braj; Schork, Nicholas J; O'Connor, Daniel T

    2012-01-01

    Hyperhomocysteinemia is associated with increased venous thrombosis and cardiovascular disease (CVD). Mutations in the human methylenetetrahydrofolate reductase (MTHFR) gene have been associated with increased homocysteine levels and risks of CVD in various populations including those with kidney disease. Here, we evaluated the influence of MTHFR variants on progressive loss of kidney function. We analyzed 821 subjects with hypertensive nephrosclerosis from the longitudinal National Institute of Diabetes and Digestive and Kidney Diseases African-American Study of Kidney Disease and Hypertension (AASK) Trial to determine whether decline in glomerular filtration rate (GFR) over ∼4.2 years was predicted by common genetic variation within MTHFR at non-synonymous positions C677T (Ala222Val) and A1298C (Glu429Ala) or by MTHFR haplotypes. The effect on GFR decline was then supported by a study of 1333 subjects from the San Diego Veterans Affairs Hypertension Cohort (VAHC), followed over ∼4.5 years. Linear effect models were utilized to determine both genotype [single-nucleotide polymorphism (SNP)] and genotype (SNP)-by-time interactions. In AASK, the polymorphism at A1298C predicted the rate of GFR decline: A1298/A1298 major allele homozygosity resulted in a less pronounced decline of GFR, with a significant SNP-by-time interaction. An independent follow-up study in the San Diego VAHC subjects supports that A1298/A1298 homozygotes have the greatest estimated GFR throughout the study. Haplotype analysis with C677T yielded concurring results. We conclude that the MTHFR-coding polymorphism at A1298C is associated with renal decline in African-Americans with hypertensive nephrosclerosis and is supported by a veteran cohort with a primary care diagnosis of hypertension. Further investigation is needed to confirm such findings and to determine what molecular mechanism may contribute to this association.

  1. Changes in Renal Function and Oxidative Status Associated with the Hypotensive Effects of Oleanolic Acid and Related Synthetic Derivatives in Experimental Animals.

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    Hlengiwe Pretty Madlala

    Full Text Available The triterpene oleanolic acid (OA is known to possess antihypertensive actions. In the present study we to compared the effects of the triterpene on mean arterial blood pressure (MAP and kidney function following acute administration in normotensive animals with those of its related oleanane synthetic derivatives (brominated oleanolic acid, Br-OA and oleanolic acid methyl ester, Me-OA. We also used experimental models of hypertension to further explore the effects of sub-chronic oral OA treatment and evaluated influences on oxidative status.OA was extracted from dried flower buds of Syzygium aromaticum using a previously validated protocol in our laboratory. Me-OA and Br-OA were synthesized according to a method described. Rats were supplemented with lithium chloride (12 mmol L-1 prior to experimentation in order to raise plasma lithium to allow measurements of lithium clearance and fractional excretion (FELi as indices of proximal tubular Na+ handling. Anaesthetized animals were continuously infused via the right jugular with 0.077M NaCl. MAP was measured via a cannula inserted in the carotid artery, and urine was collected through a cannula inserted in the bladder. After a 3.5 h equilibration, MAP, urine flow, electrolyte excretion rates were determined for 4 h of 1 h control, 1.5 h treatment and 1.5 h recovery periods. OA, Me-OA and Br-OA were added to the infusate during the treatment period. We evaluated sub-chronic effects on MAP and kidney function in normotensive Wistar rats and in two animal models of hypertension, spontaneously hypertensive rats (SHR and Dahl salt-sensitive (DSS rats, during 9-week administration of OA (p.o.. Tissue oxidative status was examined in these animals at the end of the study. Increasing evidence suggests that and renal function disturbances and oxidative stress play major roles in the pathogenesis of hypertension.Acute infusion OA and oleanane derivatives displayed qualitatively similar effects in decreasing

  2. Disfunção renal e marcadores inflamatórios em hipertensos atendidos em hospital universitário Renal dysfunction and inflammatory markers in hypertensive patients seen in a university hospital

    Directory of Open Access Journals (Sweden)

    Fátima Lúcia Machado Braga

    2013-01-01

    to support interventions that can slow the progression of renal function loss. OBJECTIVE: To analyze the magnitude of the renal function deficit in hypertensive adult patients and its relationship with the following inflammatory markers: high-sensitivity C reactive protein, erythrocyte sedimentation rate, and neutrophil/lymphocyte ratio. METHODS: Cross-sectional study including 1,273 adult hypertensive patients of both genders, of whom 1,052 had renal function deficit, and 221 had no deficit, as diagnosed by the Modification of Diet in Renal Disease equation. The odds ratio (OR and the prevalence ratio (PR were used to determine the probability of the occurrence of inflammatory activity in renal disease. RESULTS: Renal function deficit was diagnosed in 82.6% of the patients assessed, and most of the sample (70.8% was classified as in stage 2 of chronic kidney disease. In the regression model, metabolic syndrome (PRadjusted = 1.09 [95%CI: 1.04-1.14], high-sensitivity C reactive protein (PRadjusted = 1.54 [95%CI: 1.40-1.69] and erythrocyte sedimentation rate (PRadjusted = 1.20 [95%CI: 1.12-1.28] remained independently associated with the renal function deficit. However, considering the individuals classified as in stage 2 of renal function deficit, the chance of abnormalities in inflammatory markers were OR = 10.25 (95%CI: 7.00-15.05 for high-sensitivity C reactive protein, OR = 8.50 (95%CI: 5.70-12.71 for neutrophil/lymphocyte ratio, and OR = 7.18 (95%CI: 4.87-10.61 for erythrocyte sedimentation rate. CONCLUSION: The results show an association of inflammatory activity and metabolic syndrome with renal function deficit.

  3. Avaliação renal de hipertensos pela clearance de creatinina num centro de saúde de Teresina-PI, Brasil Evaluación renal de hipertensos en el aclaramiento de creatinina en un centro sanitario de Teresina- PI, Brasil Evaluation of renal hypertensive by creatinine clearance in a health center in Teresina-pi, Brazil

    Directory of Open Access Journals (Sweden)

    Dinah Sá Rezende Neta

    2012-03-01

    Full Text Available A Hipertensão Arterial Sistémica é uma das principais causas de Insuficiência Renal Crónica. Estudo de abordagem quantitativa, desenvolvido no Centro de Saúde Porto Alegre e que teve como objetivo avaliar a função renal de pacientes com hipertensão pela clearance de creatinina, a partir da mensuração da creatinina sérica. Foi realizado levantamento de dados a partir de consultas de enfermagem e solicitados exames de creatinina sérica. Após o cálculo da clearance de creatinina pela equação de Cockcroft-Gault classificou-se os pacientes em um dos seis estágios da Doença Renal Crónica. Os resultados evidenciaram que 74% da amostra apresentou lesão renal, o que mostra o quanto é importante a avaliação periódica da função renal dos pacientes com hipertensão para que possam ser acompanhados quanto a progressão da Doença Renal Crónica.Hipertensión Arterial Sistémica es una de las principales causas de Insuficiencia Renal Crónica. Por ello, este estudio tuvo por objetivo evaluar la función renal de los pacientes con hipertensión por medio del aclaramiento de creatinina, a partir de la medición de la creatinina sérica. Estudio de enfoque cuantitativo, elaborado en el Centro de Salud de Porto Alegre. La recolección de datos ocurrió en consultas de enfermería y fueron se solicitaron pruebas de la creatinina sérica. Tras realizar el cálculo del aclaramiento de la creatinina mediante la fórmula Cockcroft-Gault, los pacientes fueron clasificados en una de las seis etapas de la Enfermedad Renal Crónica. Los resultados revelaron que 74% de la muestra presentaron daño renal, lo cual demuestra cuán importante es la evaluación periódica de la función renal de los pacientes con hipertensión para que se les pueda controlada la progresión de la Enfermedad Renal Crónica.Systemic arterial hypertension is a leading cause of chronic renal failure. Thus, this study aimed at assessing the renal function of patients with

  4. Nebivolol reduces central blood pressure in stage I hypertensive patients: experimental single cohort study

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    Renan Oliveira Vaz-de-Melo

    Full Text Available CONTEXT AND OBJECTIVES: Assessment of central blood pressure (BP has grown substantially over recent years because evidence has shown that central BP is more relevant to cardiovascular outcomes than peripheral BP. Thus, different classes of antihypertensive drugs have different effects on central BP despite similar reductions in brachial BP. The aim of this study was to investigate the effect of nebivolol, a β-blocker with vasodilator properties, on the biochemical and hemodynamic parameters of hypertensive patients.DESIGN AND SETTING: Experimental single cohort study conducted in the outpatient clinic of a university hospital.METHODS: Twenty-six patients were recruited. All of them underwent biochemical and hemodynamic evaluation (BP, heart rate (HR, central BP and augmentation index before and after 3 months of using nebivolol.RESULTS: 88.5% of the patients were male; their mean age was 49.7 ± 9.3 years and most of them were overweight (29.6 ± 3.1 kg/m2 with large abdominal waist (102.1 ± 7.2 cm. There were significant decreases in peripheral systolic BP (P = 0.0020, diastolic BP (P = 0.0049, HR (P < 0.0001 and central BP (129.9 ± 12.3 versus 122.3 ± 10.3 mmHg; P = 0.0083 after treatment, in comparison with the baseline values. There was no statistical difference in the augmentation index or in the biochemical parameters, from before to after the treatment.CONCLUSIONS: Nebivolol use seems to be associated with significant reduction of central BP in stage I hypertensive patients, in addition to reductions in brachial systolic and diastolic BP.

  5. Mineralocorticoid hypertension

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

  6. Renal redox-sensitive signaling, but not blood pressure, is attenuated by Nox1 knockout in angiotensin II-dependent chronic hypertension.

    Science.gov (United States)

    Yogi, Alvaro; Mercure, Chantal; Touyz, Joshuah; Callera, Glaucia E; Montezano, Augusto C I; Aranha, Anna B; Tostes, Rita C; Reudelhuber, Timothy; Touyz, Rhian M

    2008-02-01

    We demonstrated previously that, in mice with chronic angiotensin II-dependent hypertension, gp91phox-containing NADPH oxidase is not involved in the development of high blood pressure, despite being important in redox signaling. Here we sought to determine whether a gp91phox homologue, Nox1, may be important in blood pressure elevation and activation of redox-sensitive pathways in a model in which the renin-angiotensin system is chronically upregulated. Nox1-deficient mice and transgenic mice expressing human renin (TTRhRen) were crossed, and 4 genotypes were generated: control, TTRhRen, Nox1-deficient, and TTRhRen Nox1-deficient. Blood pressure and oxidative stress (systemic and renal) were increased in TTRhRen mice (Pblood pressure is elevated despite reduced NADPH oxidase activation, decreased oxidative stress, and attenuated redox signaling. Our results suggest that Nox1-containing NADPH oxidase plays a key role in the modulation of systemic and renal oxidative stress and redox-dependent signaling but not in the elevation of blood pressure in a model of chronic angiotensin II-dependent hypertension.

  7. Angiotensin converting enzyme (ACE) inhibitors and renal function. A review of the current status

    DEFF Research Database (Denmark)

    Kamper, A L

    1991-01-01

    Angiotensin converting enzyme (ACE) inhibitors are well established in the treatment of hypertension and cardiac failure. Experimental studies in rats have suggested that these agents may protect renal function in chronic nephropathy by a mechanism other than simply lowering the systemic blood...... and therapy should be started cautiously in this setting, with close monitoring of blood pressure, renal function and plasma potassium....

  8. Long-Term Effects of Maternal Citrulline Supplementation on Renal Transcriptome Prevention of Nitric Oxide Depletion-Related Programmed Hypertension: The Impact of Gene-Nutrient Interactions

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    You-Lin Tain

    2014-12-01

    Full Text Available Maternal malnutrition can elicit gene expression leading to fetal programming. l-citrulline (CIT can be converted to l-arginine to generate nitric oxide (NO. We examined whether maternal CIT supplementation can prevent NG-nitro-l-arginine-methyl ester (l-NAME, NO synthase inhibitor-induced programmed hypertension and examined their effects on the renal transcriptome in male offspring using next generation RNA sequencing (RNA-Seq technology. Pregnant Sprague-Dawley rats received l-NAME administration at 60mg/kg/day subcutaneously via osmotic minipump during pregnancy alone or with additional 0.25% l-citrulline solution in drinking water during the whole period of pregnancy and lactation. Male offspring were assigned to three groups: control, l-NAME, and l-NAME + CIT. l-NAME exposure induced hypertension in the 12-week-old offspring, which CIT therapy prevented. Identified differentially expressed genes in l-NAME and CIT-treated offspring kidneys, including Guca2b, Hmox1, Hba2, Hba-a2, Dusp1, and Serpine1 are related to regulation of blood pressure (BP and oxidative stress. In conclusion, our data suggests that the beneficial effects of CIT supplementation are attributed to alterations in expression levels of genes related to BP control and oxidative stress. Our results suggest that early nutritional intervention by CIT has long-term impact on the renal transcriptome to prevent NO depletion-related programmed hypertension. However, our RNA-Seq results might be a secondary phenomenon. The implications of epigenetic regulation at an early stage of programming deserve further clarification.

  9. Impact of Levovist ultrasonographic contrast agent on the diagnosis and management of hypertensive patients with suspected renal artery stenosis: a Canadian multicentre pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Lacourciere, Y.; Levesque, J. [Centre Hospitalier de l' Universite du Quebec (Canada); Centre Hospitalier de l' Universite Laval, Sainte-Foy, Quebec (Canada); Onrot, J.M. [St. Paul' s Hospital, Vancouver, British Columbia (Canada)] [and others

    2002-10-01

    To compare the diagnoses obtained with unenhanced ultrasonography (US), contrast-enhanced US and captopril-enhanced renal scintigraphy and to determine whether use of a contrast agent improves ability to assess the renal arteries with duplex Doppler US. The study was an open-label controlled trial involving 78 patients with hypertension suspected to have a renovascular cause. The patients underwent captopril-enhanced scintigraphy or routine unenhanced US (the usual diagnostic methods at the centres where the study was conducted) and contrast-enhanced US (with Levovist, Berlex Canada, Lachine, Que.). The patients were followed for 3 months after the diagnostic tests were performed. Enhanced US yielded a diagnosis for a significantly greater proportion of patients than did unenhanced US (77 [99%] v. 64 [82%] of 78 patients; p = 0.002) or captopril-enhanced scintigraphy (71 [99%] v. 58 [81%] of 72 patients; p = 0.002). Diagnosis was possible with both enhanced and unenhanced duplex Doppler US in only 64 (82%) of the 78 patients, and the diagnosis was the same with both methods for 63 (98%) of these 64 patients. In contrast, diagnosis was possible for only 58 (81%) of the 72 patients who underwent both enhanced US and captopril-enhanced scintigraphy; the same diagnosis was reported in 53 (91%) of these 58 cases. During followup, 11 patients (21 kidneys) underwent angiography. Significant stenosis was detected in 6 (55%) of the patients (8 [38%] of the kidneys). Both the enhanced and unenhanced US results agreed more often with angiography than did captopril-enhanced scintigraphy (9 [82%] v. 8 [73%] of the 11 patients). The proportion of patients in whom the left and right renal artery could be assessed by duplex Doppler US increased significantly (by 58% and 43%, respectively) with use of the contrast agent. Enhanced US had a higher rate of successful diagnosis than unenhanced US and captopril-enhanced renal scintigraphy. Enhanced US might therefore be suitable as a

  10. Relationship of endothelial dysfunction with degree of renal function damage and lipidemic profile in patients with type 2 diabetes mellitus and hypertension

    Directory of Open Access Journals (Sweden)

    Pertseva N.O.

    2014-09-01

    Full Text Available In the article defining relationship between endothelial dysfunction, the degree of renal and lipidemic profile damage in 234 patients with type 2 diabetes mellitus with hypertension was carried depending on the quality of glycemic control. It is shown that the deepening of endothelial dysfunction in patients with insufficient and poor compensation tightly correlates with the degree of renal and lipidemic disorders. In these patients there was a significant increase in the level of albuminuria, reduction in glomerular filtration rate, increase of concentrations of urea and creatinine. Against the background of poor hyperglycemia, compensation total cholesterol, low density lipoprotein content increases by 73,3% (p<0.05, hype¬rtriglyceridemia twice exceeds the control values. In patients with type 2 diabetes mellitus with poor compensation the most significant correlation links were observed between the concentration of endothelin-1 and the level of microalbuminuria (r=+0,79, as well as the content of low density lipoprotein cholesterol (r=+0.81. Thrombomodulin concentration is in direct correlation with microalbuminuria (r=+0.76, hypercholesterolemia (r=+0.80 and hypertriglyceridemia (r=+0.83, indicating to increasing interaction between the pathogenetic mechanisms which cause depression of endothelial dysfunction, renal and dyslipidemic disorders with increasing hyperglycemia.

  11. Sex-Differences in Renal Expression of Selected Transporters and Transcription Factors in Lean and Obese Zucker Spontaneously Hypertensive Fatty Rats

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    Andrea Babelova

    2015-01-01

    Full Text Available The aim of this study was to identify sex-dependent expression of renal transporter mRNA in lean and obese Zucker spontaneously hypertensive fatty (ZSF1 rats and to investigate the interaction of the most altered transporter, organic anion transporter 2 (Oat2, with diabetes-relevant metabolites and drugs. Higher incidence of glomerulosclerosis, tubulointerstitial fibrosis, and protein casts in Bowman’s space and tubular lumen was detected by PAS staining in obese male compared to female ZSF1 rats. Real-time PCR on RNA isolated from kidney cortex revealed that Sglt1-2, Oat1-3, and Oct1 were higher expressed in kidneys of lean females. Oct2 and Mrp2 were higher expressed in obese males. Renal mRNA levels of transporters were reduced with diabetic nephropathy in females and the expression of transcription factors Hnf1β and Hnf4α in both sexes. The highest difference between lean and obese ZSF1 rats was found for Oat2. Therefore, we have tested the interaction of human OAT2 with various substances using tritium-labeled cGMP. Human OAT2 showed no interaction with diabetes-related metabolites, diabetic drugs, and ACE-inhibitors. However, OAT2-dependent uptake of cGMP was inhibited by furosemide. The strongly decreased expression of Oat2 and other transporters in female diabetic ZSF1 rats could possibly impair renal drug excretion, for example, of furosemide.

  12. [Hypertension in the elderly].

    Science.gov (United States)

    Handschin, Anja; Henny-Fullin, Katja; Buess, Daniel; Leuppi, Jörg; Dieterle, Thomas

    2015-06-01

    Arterial hypertension remains the most important risk factor for cardiovascular and renal diseases. In view of an increasing prevalence with older age and an increasingly aging population, the treatment of elderly patients with arterial hypertension will become increasingly important in daily practice. Arterial hypertension in the elderly differs in many aspects from arterial hypertension in younger patients. For example, isolated systolic hypertension is the predominant form of arterial hypertension in the elderly. In comparison to younger patients, treatment of hypertension in the elderly is less well investigated. However, available data suggest that lowering of blood pressure in the elderly and very elderly reduces the risk of heart failure, stroke, and even mortality. The best evidence for the treatment of hypertension in the elderly exists for diuretics and calcium antagonists. However, the primary choice of antihypertensive therapy should be guided by the presence of existing cardiovascular and/or renal comorbidities.

  13. Protective effect of theophylline on renal functions in experimental pneumoperitoneum model.

    Science.gov (United States)

    Ozturk, Sefa Alperen; Ceylan, Cavit; Serel, Tekin Ahmet; Doluoglu, Omer Gokhan; Soyupek, Arap Sedat; Guzel, Ahmet; Özorak, Alper; Uz, Efkan; Savas, Hasan Basri; Baspinar, Sirin

    2015-07-01

    Our objective in this experimental study is to research the effect of the intra-abdominal pressure which rises following pneumoperitoneum and whether Theophylline has a possible protective activity on this situation. In our study, 24 Wistar Albino rats were used. Rats were divided into two groups. The first group was set for only pneumoperitoneum model. The second group was given 15 mg/kg of Theophylline intraperitoneally before setting pneumoperitoneum model. Then urea, creatinine, cystatin-C, tissue and serum total antioxidant capacity, total oxidant capacity and oxidative stress index in two groups were measured and compared with each other. Apoptosis and histopathological conditions in the renal tissues were examined. The differences between the groups were analyzed with the Mann-Whitney U test. Results were considered significant at p OSI values (p > 0.05). The mean value of urea were similar in pneumoperitoneum and pneumoperitoneum + theophylline groups (p = 0.12). The mean cystatin-C value was 2.2 ± 0.3 µg/mL in pneumoperitoneum, 1.74 ± 0.33 µg/mL in pneumoperitoneum + theophylline (p = 0.002). According to our study, lower cystatin-C levels in the group, where Theophylline was given, are suggestive of lower renal injury in this group. However, this opinion is interrogated as there is no difference in terms of tissue and serum TAS, TOS, OSI and urea values between the groups.

  14. RENAL ISCHEMIA-REPERFUSION INJURY CONTRIBUTES TO RENAL DAMAGE IN EXPERIMENTAL ANTI-MYELOPEROXIDASE-ASSOCIATED PROLIFERATIVE GLOMERULONEPHRITIS

    NARCIS (Netherlands)

    BROUWER, E.; Klok, P.A; HUITEMA, M.G.; Weening, J.J.; Kallenberg, Cees

    The occurrence of focal fibrinoid necrosis of capillary loops in the very early stages of ANCA-associated necrotizing crescentic glomerulonephritis (NCGN) and the increased prevalence of this disease at older age suggest that renal ischemia may play an additional role in its pathophysiology. In the

  15. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie

    2014-01-01

    Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after a th...

  16. Recombinant human interferon alpha 2b prevents and reverses experimental pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Eileen M Bauer

    Full Text Available Pulmonary hypertension (PH is a progressive and fatal disease with no cure. Vascular remodeling in PH involves intraluminal growth of endothelial and smooth muscle cells, leading to obliterative vascular lesions. Cell growth in these lesions is quasi-neoplastic, with evidence of monoclonality, apoptosis resistance and cancer-like metabolic derangements. Herein we tested the effect of human interferon alpha 2b (IFNα, a pleiotropic cytokine and anti-cancer therapeutic, on the development and progression of PH in the rat SU5416/hypoxia (SUH model and mouse hypoxia model of the disease. In both models IFNα attenuated the development of PH and reversed established PH as assessed by measuring right ventricular systolic pressure and right ventricular hypertrophy. The effect of IFNα was dependent on the type I interferon receptor (IFNAR since mice lacking a subunit of the IFNAR were not protected by IFNα. Morphometric analysis of pulmonary aterioles from hypoxic mice or SUH rats showed that IFNα inhibited pulmonary vascular remodeling in both models and that IFNα reversed remodeling in SUH rats with established disease. Immunohistochemical staining revealed that IFNα decreased the number of PCNA and Tunel positive cells in the wall of pulmonary arterioles. In vitro, IFNα inhibited proliferation of human pulmonary artery smooth muscle cells and as well as human pulmonary artery endothelial cell proliferation and apoptosis. Together these findings demonstrate that IFNα reverses established experimental PH and provide a rationale for further exploration of the use of IFNα and other immunotherpies in PH.

  17. Elevated lipoprotein(a), hypertension and renal insufficiency as predictors of coronary artery disease in patients with genetically confirmed heterozygous familial hypercholesterolemia.

    Science.gov (United States)

    Chan, Dick C; Pang, Jing; Hooper, Amanda J; Burnett, John R; Bell, Damon A; Bates, Timothy R; van Bockxmeer, Frank M; Watts, Gerald F

    2015-12-15

    Familial hypercholesterolemia (FH) is characterized by elevated LDL-cholesterol and increased risk of premature coronary artery disease (CAD). Lipoprotein(a) [Lp(a)] increases CAD in FH, although the independence of this association relative to other CAD risk factors remains unclear. In this study, we examined the association between Lp(a) and other cardiovascular risk factors and prevalent CAD in patients with FH. A cross-sectional study of 390 patients with genetically confirmed FH were studied. Clinical and biochemical parameters of FH patients with and without CAD were compared. FH patients with CAD were older and more often male and had a higher prevalence of hypertension, smoking, diabetes, obesity, reduced eGFR, and elevated plasma Lp(a) and pre-treatment LDL-cholesterol and triglyceride (or low HDL-cholesterol) than FH patients without CAD (P<0.05 for all). In univariate analyses, age, male gender, smoking, hypertension, reduced eGFR, diabetes, obesity, plasma creatinine, Lp(a) and pretreatment LDL-cholesterol, triglycerides and HDL-cholesterol levels were significant predictors of CAD in the FH patients (P<0.05 for all). Elevated LDL-cholesterol, raised Lp(a), hypertension and reduced eGFR remained significant independent predictors of CAD (P<0.05 for all) in FH after adjusting for other modifiable risk factors. Elevated Lp(a), hypertension and renal insufficiency are independent risk factors beyond elevated pretreatment LDL-cholesterol which predict CAD in patients with FH. In spite of the cross-sectional design of our study, we propose the need for identifying and managing these abnormalities to reduce excess CAD risk in FH patients. However, this proposal remains to be formally tested in a prospective study. Copyright © 2015. Published by Elsevier Ireland Ltd.

  18. Dietary sodium modulation of aldosterone activation and renal function during the progression of experimental heart failure.

    Science.gov (United States)

    Miller, Wayne L; Borgeson, Daniel D; Grantham, J Aaron; Luchner, Andreas; Redfield, Margaret M; Burnett, John C

    2015-02-01

    Aldosterone activation is central to the sodium–fluid retention that marks the progression of heart failure (HF). The actions of dietary sodium restriction, a mainstay in HF management, on cardiorenal and neuroendocrine adaptations during the progression of HF are poorly understood. The study aim was to assess the role of dietary sodium during the progression of experimental HF. Experimental HF was produced in a canine model by rapid right ventricular pacing which evolves from early mild HF to overt, severe HF. Dogs were fed one of three diets: (i) high sodium [250 mEq (5.8 g) per day, n =6]; (ii) standard sodium [58 mEq (1.3 g) per day, n =6]; and (iii) sodium restriction [11 mEq (0.25 g) per day, n =6]. During the 38-day study, haemodynamics, renal function, plasma renin activity (PRA), and aldosterone were measured. Changes in haemodynamics at 38 days were similar in all three groups, as were changes in renal function. Aldosterone activation was demonstrated in all three groups; however, dietary sodium restriction, in contrast to high sodium, resulted in early (10 days) activation of PRA and aldosterone. High sodium demonstrated significant suppression of aldosterone activation over the course of HF progression. Excessive dietary sodium restriction particularly in early stage HF results in early aldosterone activation, while normal and excess sodium intake are associated with delayed or suppressed activation. These findings warrant evaluation in humans to determine if dietary sodium manipulation, particularly during early stage HF, may have a significant impact on neuroendocrine disease progression.

  19. Influence of montelukast on cisplatin-induced experimental acute renal failure.

    Science.gov (United States)

    Teslariu, Oana; Nechifor, M; Plămădeală, P; Miron, Ingrith Crenguţa

    2014-01-01

    To investigate the influence of Montelukast (MK) in acute renal failure (ARF) experimentally induced by cisplatin (CIS). The experiment was carried out in male Wistar rats (280-320g), divided into 4 groups of 12 animals each, treated as follows: Group I (Control); Group II (CIS): CIS, 5 mg/kbw, single dose, i.p.; Group III (CISMK): CIS, 5 mg/kbw, single dose, i.p and MK 2 mg/kbw, p.o., 10 days; Group IV (MK): MK 2 mg/kbw, p.o., 10 days. Blood and urine (24 h) samples were taken before the start of experiment (Io) and at 3, 7, 10 and 14 days after CIS administration. The following were determined: urea, creatinine, Ca, Mg serum levels and creatinine, proteins, Ca and Mg urinary levels. For histological evaluation, 3 rats of each group were sacrificed at 3, 7, 10 and 14 days. The severity of histopathological changes was evaluated using scores on a 1-4 point scale. Both in CIS and CISMK group, serum levels of urea and creatinine and urinary protein levels were significantly higher compared with Io values and control group at 3 and 7 days, (p < 0.01 and p < 0.05, respectively). Urinary creatinine levels were significantly decreased at 3 and 7 days, (p < 0.01) and (p < 0.05) in CIS and CISMK group compared to Io and control group. The degree of severity of histopathological changes was similar in CIS and CISMK group. The obtained results showed that MK at a dose of 2 mg/kbw had no protective effect in CIS-induced experimental acute renal failure.

  20. [sup 99m]TC-MAG[sub 3] renal function scintigraphy and captopril in the diagnosis of renovascular hypertension. [sup 99m]Tc-MAG[sub 3]-Nierenfunktionsszintigraphie ohne und mit Captopril zur Diagnostik der renovaskulaeren Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Piepenburg, R. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Bockisch, A. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Andreas, J. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Dueber, C. (Mainz Univ. (Germany). Klinik fuer Roentgendiagnostik); Kann, P. (Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik, Innere Medizin und Endokrinologie); Maier, G. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin); Hahn, K. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Nuklearmedizin)

    1993-08-01

    In this study, the diagnostic value of renal function scintigraphy performed both without and with ACE inhibition has been evaluated using the new radiopharmaceutical [sup 99m]Tc-MAG[sub 3]. In cases of decompensated renal artery stenoses, the typical scan finding with this tubular excreted agent was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. Using this criterion in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89 and 88%, respectively. Bilateral positive findings were non-specific; excluding them from the study, specificity increased to 100%. In renal insufficiency, captopril scans seem to be of reduced diagnostic value. Summarising our experiences, renal function scintigraphy using [sup 99m]Tc-MAG[sub 3] without and with captopril was proved to be a reliable non-invasive method to detect or exclude haemodynamically relevant renal artery stenosis. (orig.)

  1. Number of ablated spots in the course of renal sympathetic denervation in CKD patients with uncontrolled hypertension: EnligHTN vs. Standard irrigated cardiac ablation catheter.

    Science.gov (United States)

    Kiuchi, M G; Chen, S; Rodrigues Paz, L M; Pürerfellner, H

    Hypertension was both a mutual cause and the main concern of chronic kidney disease (CKD). Blood pressure control is more problematic in the company of CKD. This study compares the effects of renal sympathetic denervation (RSD) on 24-h ambulatory blood pressure measurements (ABPM) and renal function in individuals with CKD and uncontrolled hypertension by unlike a number of ablated spots using the EnligHTN catheter and the standard irrigated cardiac ablation catheter (SICAC), Flexability. The 112 subjects were randomly divided into two groups according to the catheter that would be used in the procedure EnligHTN (n=56) or Flexability (n=56). Into each group, we created 5 subgroups according to the number of ablated spots: 4, 8, 12, 16 and 20. All of them were followed for exactly 6 months to assess all the parameters measured in this investigation. Comparing the Δ 24-h systolic ABPM according to the number of ablated spots 4 and 20 for EnligHTN vs. Flexability, respectively, the differences were: -3.6±0.9 vs. -6.3±1.4mmHg (P<0.0001), and -13.9±4.8 vs. -36.3±4.3mmHg (P<0.0001). The comparisons between Δ estimated glomerular filtration rate (eGFR) according to the number of ablated spots 4 and 20 for EnligHTN vs. Flexability, respectively, were: +2.7±4.0 vs. +6.0±8.4mL/min/1.73m 2 (P=0.2287), and +11.9±6.0 vs. +21.4±8.7mL/min/1.73m 2 (P=0.0222). The RSD reduced the mean 24-h ABPM in subjects with CKD and uncontrolled hypertension and improved the renal function in both groups. These effects were more marked and important in subgroups underwent a great number of ablated spots using the SICAC. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Cost-effectiveness of early irbesartan treatment versus control (standard antihypertensive medications excluding ACE inhibitors, other angiotensin-2 receptor antagonists, and dihydropyridine calcium channel blockers) or late irbesartan treatment in patients with type 2 diabetes, hypertension, and renal disease

    NARCIS (Netherlands)

    Palmer, Andrew J; Annemans, Lieven; Roze, Stéphane; Lamotte, Mark; Lapuerta, Pablo; Chen, Roland; Gabriel, Sylvie; Carita, Paulo; Rodby, Roger A; de Zeeuw, Dick; Parving, Hans-Henrik

    OBJECTIVE: The aim of this study was to determine the most cost-effective time point for initiation of irbesartan treatment in hypertensive patients with type 2 diabetes and renal disease. RESEARCH DESIGN AND METHODS: This study was a Markov model-simulated progression from microalbuminuria to overt

  3. Treprostinil in advanced experimental pulmonary hypertension : Beneficial outcome without reversed pulmonary vascular remodeling

    NARCIS (Netherlands)

    van Albada, Mirjam E.; van Veghel, Richard; Cromme-Dijkhuis, Adri H.; Schoemaker, Regien G.; Berger, Ro F. M. E.

    2006-01-01

    Introduction: Beneficial effects of treprostmil, a stable prostacyclin analogue, were demonstrated in patients with pulmonary arterial hypertension (PAH). Although regression of pulmonary vascular remodeling has been suggested as therapeutic mechanism, its mode of action remains unknown. Methods:

  4. Right ventricular oxygen supply parameters are decreased in human and experimental pulmonary hypertension

    NARCIS (Netherlands)

    Ruiter, G.; Wong, Y.Y.; de Man, F.S.; Handoko, M.L.; Jaspers, R.T.; Postmus, P.E.; Westerhof, N.; Niessen, H.W.M.; van der Laarse, W.J.; Vonk Noordegraaf, A.

    2013-01-01

    Background: In pulmonary arterial hypertension (PAH), high right ventricular (RV) power output requires increased myocardial oxygen consumption. Oxygen supply, however, does not increase in proportion. It is unknown what cellular mechanisms underlie this lack of adaptation. We therefore determined

  5. Relationship of hyperglycemia with endothelial function, renal function, lipidemic profile, and morphological changes of blood cells in patients with insufficient compensation of type 2 diabetes mellitus with hypertension

    Directory of Open Access Journals (Sweden)

    N. O. Pertseva

    2014-12-01

    Full Text Available Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. It has been established that in the insufficient glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis (up to r=+0.95 formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes.

  6. Screening for elevated albuminuria and subsequently hypertension identifies subjects in which treatment may be warranted to prevent renal function decline.

    Science.gov (United States)

    Özyilmaz, Akin; de Jong, Paul E; Bakker, Stephan J L; Visser, Sipke T; Thio, Chris; Gansevoort, Ron T

    2017-04-01

    We investigated whether initial population screening for elevated albuminuria with subsequent screening for hypertension in case albuminuria is elevated may be of help to identify subjects at risk for accelerated decline in kidney function. We included subjects who participate in the PREVEND observational, general population-based cohort study and had two or more glomerular filtration rate (eGFR) measurements available during follow-up. Elevated albuminuria was defined as an albumin concentration ≥20 mg/L in a first morning urine sample confirmed by an albumin excretion ≥30 mg/day in two 24-h urines. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or use of blood pressure-lowering drugs. eGFR was estimated with the CKD-EPI creatinine-cystatin C equation. Overall, 6471 subjects were included with a median of 4 [95% confidence interval (CI) 2-5] eGFR measurements during a follow-up of 11.3 (95% CI 4.0-13.7) years. Decline in eGFR was greater in the subgroups with elevated albuminuria. This held true, not only in subjects with known hypertension (-1.84 ± 2.27 versus -1.16 ± 1.45 mL/min/1.73 m 2 per year, P albuminuria had higher blood pressure than subjects with normoalbuminuria, and in subjects with elevated albuminuria as yet undiagnosed hypertension was twice as prevalent as diagnosed hypertension. Initial screening for elevated albuminuria followed by screening for hypertension may help to detect subjects with increased risk for a steeper decline in kidney function.

  7. VIP and endothelin receptor antagonist: An effective combination against experimental pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Szema Anthony M

    2011-10-01

    Full Text Available Abstract Background Pulmonary Arterial Hypertension (PAH remains a therapeutic challenge, and the search continues for more effective drugs and drug combinations. We recently reported that deletion of the vasoactive intestinal peptide (VIP gene caused the spontaneous expression of a PH phenotype that was fully corrected by VIP. The objectives of this investigation were to answer the questions: 1 Can VIP protect against PH in other experimental models? and 2 Does combining VIP with an endothelin (ET receptor antagonist bosentan enhance its efficacy? Methods Within 3 weeks of a single injection of monocrotaline (MCT, s.c. in Sprague Dawley rats, PAH developed, manifested by pulmonary vascular remodeling, lung inflammation, RV hypertrophy, and death within the next 2 weeks. MCT-injected animals were either untreated, treated with bosentan (p.o. alone, with VIP (i.p. alone, or with both together. We selected this particular combination upon finding that VIP down-regulates endothelin receptor expression which is further suppressed by bosentan. Therapeutic outcomes were compared as to hemodynamics, pulmonary vascular pathology, and survival. Results Treatment with VIP, every other day for 3 weeks, begun on the same day as MCT, almost totally prevented PAH pathology, and eliminated mortality for 45 days. Begun 3 weeks after MCT, however, VIP only partially reversed PAH pathology, though more effectively than bosentan. Combined therapy with both drugs fully reversed the pathology, while preventing mortality for at least 45 days. Conclusions 1 VIP completely prevented and significantly reversed MCT-induced PAH; 2 VIP was more effective than bosentan, probably because it targets a wider range of pro-remodeling pathways; and 3 combination therapy with VIP plus bosentan was more effective than either drug alone, probably because both drugs synergistically suppressed ET-ET receptor pathway.

  8. Comparison of sodium, potassium, calcium, magnesium, zinc, copper and iron concentrations of elements in 24-h urine and spot urine in hypertensive patients with healthy renal function.

    Science.gov (United States)

    Zhang, Tianjing; Chang, Xiaoyu; Liu, Wanlu; Li, Xiaoxia; Wang, Faxuan; Huang, Liping; Liao, Sha; Liu, Xiuying; Zhang, Yuhong; Zhao, Yi

    2017-12-01

    Sodium, potassium, calcium, magnesium, zinc, copper and iron are associated with the sequela of hypertension. The most reliable method for testing those elements is by collecting 24-h urine samples. However, this is cumbersome and collection of spot urine is more convenient in some circumstance. The aim of this study was to compare the concentrations of different elements in 24-h urine and spot urine. Data was collected from a sub-study of China Salt Substitute and Stroke Study. 240 participants were recruited randomly from 12 villages in two counties in Ningxia, China. Both spot and 24-h urine specimens were collected from each patient. Routine urine test was conducted, and concentration of elements was measured using microwave digestion and Inductively Coupled Plasma-Optical Emission Spectrometry. Partial correlation analysis and Spearman correlation analysis were used to investigate the concentration of different elements and the relationship between 24- h urine and spot urine. A partial correlation in sodium, potassium, calcium, magnesium and iron was found between paired 24-h urine and spot urine samples except copper and zinc: 0.430, 0.426, 0.550, 0.221 and 0.191 respectively. Spot urine can replace 24-h urine for estimating some of the elements in hypertensive patients with normal renal function. Copyright © 2017 Elsevier GmbH. All rights reserved.

  9. Effect of maturation on renal Na+/K+-ATPase and its susceptibility to nitric oxide-deficient hypertension in rats

    Czech Academy of Sciences Publication Activity Database

    Javorková, V.; Vlkovicová, J.; Kuneš, Jaroslav; Pecháňová, Olga; Zicha, Josef; Vrbjar, N.

    2007-01-01

    Roč. 34, č. 7 (2007), s. 617-623 ISSN 0305-1870 R&D Projects: GA MZd(CZ) NR7786 Grant - others:-(SK) APVT 051-027404; -(SK) VEGA 2/4123/4 Institutional research plan: CEZ:AV0Z50110509 Keywords : hypertension * kidney * nitric oxide Subject RIV: ED - Physiology Impact factor: 2.038, year: 2007

  10. Urinary Magnesium Excretion and Risk of Hypertension The Prevention of Renal and Vascular End-Stage Disease Study

    NARCIS (Netherlands)

    Joosten, Michel M.; Gansevoort, Ron T.; Mukamal, Kenneth J.; Kootstra-Ros, J.E.; Feskens, Edith J. M.; Geleijnse, Johanna M.; Navis, Gerjan; Bakker, Stephan J. L.

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this

  11. Urinary magnesium excretion and risk of hypertension. The prevention of renal and vascular end-stage disease study

    NARCIS (Netherlands)

    Joosten, M.M.; Gansevoort, R.T.; Mukamal, K.J.; Kootstra-Ros, J.E.; Feskens, E.J.M.; Geleijnse, J.M.; Navis, G.; Bakker, S.J.L.

    2013-01-01

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this

  12. Increased expression of (pro)renin receptor does not cause hypertension or cardiac and renal fibrosis in mice

    NARCIS (Netherlands)

    Rosendahl, Alva; Niemann, Gianina; Lange, Sascha; Ahadzadeh, Erfan; Krebs, Christian; Contrepas, Aurelie; van Goor, Harry; Wiech, Thorsten; Bader, Michael; Schwake, Michael; Peters, Judith; Stahl, Rolf; Nguyen, Genevieve; Wenzel, Ulrich

    Binding of renin and prorenin to the (pro)renin receptor (PRR) increases their enzymatic activity and upregulates the expression of pro-fibrotic genes in vitro. Expression of PRR is increased in the heart and kidney of hypertensive and diabetic animals, but its causative role in organ damage is

  13. APOL1 Risk Alleles Are Associated With More Severe Arteriosclerosis in Renal Resistance Vessels With Aging and Hypertension

    Directory of Open Access Journals (Sweden)

    Michael D. Hughson

    2016-05-01

    Discussion: With the limitation of the small number of subjects contributing to the positive results, the findings imply that APOL1 risk alleles recessively augment small-vessel arteriosclerosis in conjunction with age and hypertension. Focal segmental glomerulosclerosis was not a significant finding, indicating that in the early stages of arterionephrosclerosis, the primary pathologic influence of APOL1 genotype is vascular rather than glomerular.

  14. The hypertensive Ren-2 transgenic rat TGR (mREN2)27 in hypertension research. Characteristics and functional aspects

    NARCIS (Netherlands)

    Langheinrich, M.; Lee, M. A.; Böhm, M.; Pinto, Y. M.; Ganten, D.; Paul, M.

    1996-01-01

    Primary human hypertension is a polygenic disorder. It is the prevalent cause of cardiovascular disease leading to cardiac failure, stroke, chronic renal failure and, ultimately to death. Several genes are involved in cardiovascular control mechanisms and their genetics are complex. Experimental

  15. Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal.

    Science.gov (United States)

    Polónia, J; Carvalho, D; Nazaré, J; Martins, L; da Silva, P M; Aguiar, C; Manso, M C; Carqueja, T

    2016-11-01

    MicRoAlbuminuria sCreening survEy (RACE) was a multicentre, observational, cross-sectional study conducted in primary health-care settings of Portugal. Here, we present a post-hoc analysis from the RACE study, assessing the renal and cardiovascular (CV) risk predictive value of two different microalbuminuria (MA) screening methods, nephelometry with 24-h urine (MA-24 h) and Micral test with occasional urine (MicralA) in patients with hypertension (HTN) with/without type 2 diabetes mellitus (T2DM). Out of 3065 patients, 1173 (38.3%) were in the HTN group without T2DM (HTN) and 1892 (61.7%) in the HTN group with T2DM (HTN+T2DM). The overall prevalence of MA was 50.6% determined by MicralA and 22.1% with MA-24 h. Urinary albumin excretion data obtained by both techniques correlated significantly (r s =0.586; Pvalue of 41% and negative predictive value of 97%. With both methods, the presence of MA was independently associated with a higher risk (1.5- to 2.9-fold) of CV and renal organ damage in both HTN and HTN+T2DM groups. MicralA, due to its high sensitivity and negative predictive value, can be considered as a valid and reliable method for MA screening in patients with HTN with/without T2DM.

  16. Time-course effects of aerobic exercise training on cardiovascular and renal parameters in 2K1C renovascular hypertensive rats

    Directory of Open Access Journals (Sweden)

    R.C.A. Maia

    2015-01-01

    Full Text Available Exercise training (Ex has been recommended for its beneficial effects in hypertensive states. The present study evaluated the time-course effects of Ex without workload on mean arterial pressure (MAP, reflex bradycardia, cardiac and renal histology, and oxidative stress in two-kidney, one-clip (2K1C hypertensive rats. Male Fischer rats (10 weeks old; 150–180 g underwent surgery (2K1C or SHAM and were subsequently divided into a sedentary (SED group and Ex group (swimming 1 h/day, 5 days/week for 2, 4, 6, 8, or 10 weeks. Until week 4, Ex decreased MAP, increased reflex bradycardia, prevented concentric hypertrophy, reduced collagen deposition in the myocardium and kidneys, decreased the level of thiobarbituric acid-reactive substances (TBARS in the left ventricle, and increased the catalase (CAT activity in the left ventricle and both kidneys. From week 6 to week 10, however, MAP and reflex bradycardia in 2K1C Ex rats became similar to those in 2K1C SED rats. Ex effectively reduced heart rate and prevented collagen deposition in the heart and both kidneys up to week 10, and restored the level of TBARS in the left ventricle and clipped kidney and the CAT activity in both kidneys until week 8. Ex without workload for 10 weeks in 2K1C rats provided distinct beneficial effects. The early effects of Ex on cardiovascular function included reversing MAP and reflex bradycardia. The later effects of Ex included preventing structural alterations in the heart and kidney by decreasing oxidative stress and reducing injuries in these organs during hypertension.

  17. Norepinephrine-evoked salt-sensitive hypertension requires impaired renal sodium chloride cotransporter activity in Sprague-Dawley rats.

    Science.gov (United States)

    Walsh, Kathryn R; Kuwabara, Jill T; Shim, Joon W; Wainford, Richard D

    2016-01-15

    Recent studies have implicated a role of norepinephrine (NE) in the activation of the sodium chloride cotransporter (NCC) to drive the development of salt-sensitive hypertension. However, the interaction between NE and increased salt intake on blood pressure remains to be fully elucidated. This study examined the impact of a continuous NE infusion on sodium homeostasis and blood pressure in conscious Sprague-Dawley rats challenged with a normal (NS; 0.6% NaCl) or high-salt (HS; 8% NaCl) diet for 14 days. Naïve and saline-infused Sprague-Dawley rats remained normotensive when placed on HS and exhibited dietary sodium-evoked suppression of peak natriuresis to hydrochlorothiazide. NE infusion resulted in the development of hypertension, which was exacerbated by HS, demonstrating the development of the salt sensitivity of blood pressure [MAP (mmHg) NE+NS: 151 ± 3 vs. NE+HS: 172 ± 4; P salt-sensitive animals, increased NE prevented dietary sodium-evoked suppression of peak natriuresis to hydrochlorothiazide, suggesting impaired NCC activity contributes to the development of salt sensitivity [peak natriuresis to hydrochlorothiazide (μeq/min) Naïve+NS: 9.4 ± 0.2 vs. Naïve+HS: 7 ± 0.1; P salt-sensitive component of NE-mediated hypertension, while chronic ANG II type 1 receptor antagonism significantly attenuated NE-evoked hypertension without restoring NCC function. These data demonstrate that increased levels of NE prevent dietary sodium-evoked suppression of the NCC, via an ANG II-independent mechanism, to stimulate the development of salt-sensitive hypertension. Copyright © 2016 the American Physiological Society.

  18. Detection of renal ischemia by in situ microdialysis - an experimental study

    DEFF Research Database (Denmark)

    Keller, Anna Krarup

    Purpose: Acute vascular thrombosis of the renal artery or vein is a feared and devastating complication after renal operations, especially transplantation. The aim of the present study was to evaluate microdialysis as a possible new tool for fast and reliable detection of renal ischemia...... in a porcine model. Material and methods: Twenty healthy anesthetized pigs were randomized to experiments on left or right kidney and into three groups: arterial ischemia (n=8); venous ischemia (n=8) and controls (n=4). One microdialysis catheter was inserted superficially in the renal cortex and one...... was placed outside, on the renal capsule. The contra lateral kidney was removed. After two hours of baseline measurements, ischemia was introduced by clamping the renal artery or vein in the first two groups. Microdialysis samples were taken every thirty minutes during baseline and the following five hours...

  19. Renal denervation

    DEFF Research Database (Denmark)

    Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup

    2015-01-01

    PURPOSE OF REVIEW: Renal denervation (RDN) has, within recent years, been suggested as a novel treatment option for patients with resistant hypertension. This review summarizes the current knowledge on this procedure as well as limitations and questions that remain to be answered. RECENT FINDINGS...

  20. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  1. Improved pulmonary vascular reactivity and decreased hypertrophic remodeling during nonhypercapnic acidosis in experimental pulmonary hypertension

    Science.gov (United States)

    Christou, Helen; Reslan, Ossama M.; Mam, Virak; Tanbe, Alain F.; Vitali, Sally H.; Touma, Marlin; Arons, Elena; Mitsialis, S. Alex; Kourembanas, Stella

    2012-01-01

    Pulmonary hypertension (PH) is characterized by pulmonary arteriolar remodeling with excessive pulmonary vascular smooth muscle cell (VSMC) proliferation. This results in decreased responsiveness of pulmonary circulation to vasodilator therapies. We have shown that extracellular acidosis inhibits VSMC proliferation and migration in vitro. Here we tested whether induction of nonhypercapnic acidosis in vivo ameliorates PH and the underlying pulmonary vascular remodeling and dysfunction. Adult male Sprague-Dawley rats were exposed to hypoxia (8.5% O2) for 2 wk, or injected subcutaneously with monocrotaline (MCT, 60 mg/kg) to develop PH. Acidosis was induced with NH4Cl (1.5%) in the drinking water 5 days prior to and during the 2 wk of hypoxic exposure (prevention protocol), or after MCT injection from day 21 to 28 (reversal protocol). Right ventricular systolic pressure (RVSP) and Fulton's index were measured, and pulmonary arteriolar remodeling was analyzed. Pulmonary and mesenteric artery contraction to phenylephrine (Phe) and high KCl, and relaxation to acetylcholine (ACh) and sodium nitroprusside (SNP) were examined ex vivo. Hypoxic and MCT-treated rats demonstrated increased RVSP, Fulton's index, and pulmonary arteriolar thickening. In pulmonary arteries of hypoxic and MCT rats there was reduced contraction to Phe and KCl and reduced vasodilation to ACh and SNP. Acidosis prevented hypoxia-induced PH, reversed MCT-induced PH, and resulted in reduction in all indexes of PH including RVSP, Fulton's index, and pulmonary arteriolar remodeling. Pulmonary artery contraction to Phe and KCl was preserved or improved, and relaxation to ACh and SNP was enhanced in NH4Cl-treated PH animals. Acidosis alone did not affect the hemodynamics or pulmonary vascular function. Phe and KCl contraction and ACh and SNP relaxation were not different in mesenteric arteries of all groups. Thus nonhypercapnic acidosis ameliorates experimental PH, attenuates pulmonary arteriolar thickening

  2. Rosuvastatin ameliorates inflammation, renal fat accumulation, and kidney injury in transgenic spontaneously hypertensive rats expressing human C-reactive protein

    Czech Academy of Sciences Publication Activity Database

    Šilhavý, Jan; Zídek, Václav; Landa, Vladimír; Šimáková, Miroslava; Mlejnek, Petr; Oliyarnyk, O.; Malínská, H.; Kazdová, L.; Mancini, M.; Pravenec, Michal

    2015-01-01

    Roč. 64, č. 3 (2015), s. 295-301 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) LH11049; GA MŠk(CZ) LL1204; GA MZd(CZ) NT14325; GA ČR(CZ) GB14-36804G Institutional support: RVO:67985823 Keywords : rosuvastatin * kidney damage * CRP * transgenic * spontaneously hypertensive rat Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.643, year: 2015

  3. Prenatally programmed hypertension: role of maternal diabetes

    Directory of Open Access Journals (Sweden)

    G.N. Gomes

    2011-09-01

    Full Text Available Epidemiological and experimental studies have led to the hypothesis of the fetal origin of adult diseases, suggesting that some adult diseases might be determined before birth by altered fetal development. Maternal diabetes subjects the fetus to an adverse environment that has been demonstrated to result in metabolic, cardiovascular and renal impairment in the offspring. The growing amount of obesity in young females in developed and some developing countries should contribute to increasing the incidence of diabetes among pregnant women. In this review, we discuss how renal and extrarenal mechanisms participate in the genesis of hypertension induced by a diabetic status during fetal development.

  4. Pazopanib-Induced Hypertension in Patients With Renal Cell Carcinoma Is Associated With Low Urine Excretion of NO Metabolites

    DEFF Research Database (Denmark)

    Tinning, Anne Robdrup; Bengtsen, Camilla; Jensen, Niels Viggo

    2018-01-01

    increased, whereas heart rate decreased significantly; urine protein/creatinine ratio increased significantly, whereas estimated glomerular filtration rate was unchanged. Urine nitrite/nitrate (NOx) and cGMP/creatinine ratios decreased significantly, whereas urine endothelin-1/creatinine ratio and FENa...... renal cell carcinoma (n=27) treated with the receptor tyrosine kinase inhibitor pazopanib were included in the study. Home blood pressure was measured, and plasma and urine samples were collected at baseline and after 4 and 8 weeks of treatment. After 4 weeks, systolic and diastolic blood pressures......+ were unchanged. In plasma, NOx, cGMP, and brain natriuretic peptide decreased significantly, whereas endothelin-1 was significantly elevated. Blood leukocyte count decreased significantly with unchanged CRP (C-reactive protein). In summary, pazopanib treatment of patients with advanced renal cell...

  5. Fractal Dimension in Quantifying Experimental-Pulmonary-Hypertension-Induced Cardiac Dysfunction in Rats.

    Science.gov (United States)

    Pacagnelli, Francis Lopes; Sabela, Ana Karênina Dias de Almeida; Mariano, Thaoan Bruno; Ozaki, Guilherme Akio Tamura; Castoldi, Robson Chacon; Carmo, Edna Maria do; Carvalho, Robson Francisco; Tomasi, Loreta Casquel; Okoshi, Katashi; Vanderlei, Luiz Carlos Marques

    2016-07-01

    Right-sided heart failure has high morbidity and mortality, and may be caused by pulmonary arterial hypertension. Fractal dimension is a differentiated and innovative method used in histological evaluations that allows the characterization of irregular and complex structures and the quantification of structural tissue changes. To assess the use of fractal dimension in cardiomyocytes of rats with monocrotaline-induced pulmonary arterial hypertension, in addition to providing histological and functional analysis. Male Wistar rats were divided into 2 groups: control (C; n = 8) and monocrotaline-induced pulmonary arterial hypertension (M; n = 8). Five weeks after pulmonary arterial hypertension induction with monocrotaline, echocardiography was performed and the animals were euthanized. The heart was dissected, the ventricles weighed to assess anatomical parameters, and histological slides were prepared and stained with hematoxylin/eosin for fractal dimension analysis, performed using box-counting method. Data normality was tested (Shapiro-Wilk test), and the groups were compared with non-paired Student t test or Mann Whitney test (p fractal dimension values were observed in group M as compared to group C (1.39 ± 0.05 vs. 1.37 ± 0.04; p fractal dimension as an effective method to evaluate cardiac morphological changes induced by ventricular dysfunction.

  6. PATHOGENESIS OF IMMUNE ALTERATIONS AND CORRECTIVE ROLE OF AMLODIPINE IN EXPERIMENTAL CHRONIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    M. V. Osikov

    2016-01-01

    Full Text Available The purpose of this study was to assess some mechanisms of changes in immune state, and to evaluate a role of amlodipine, a known calcium channel blocker, as a potential corrective drug in experimental chronic renal failure (CRF. An animal CRF model was produced in rats by a two-stage operative resection of 5/6 of the renal tissue. Amlodipine is used per os at a daily dose of 0.25 mg/kg for 7 days. Flow cytofluorimetric approach was used to discern peripheral blood lymphocytes: CD3+ (mainly, T lymphocytes, CD45RA+ (mainly, B cells, as well as the following cell markers: Annexin 5-FITC+/7-AAD- (early apoptosis, Annexin 5-FITC+/7-AAD+ (late apoptosis and, in part, necrotic cells. Moreover, we have measured serum concentrations of urea, creatinine, phosphate, total calcium, parathyroid hormone (PTH, IL-1β, IL-4, interferon-γ, superoxide dismutase (SOD and catalase activities. Evaluation of Th1- and Th2-dependent immune response was carried out, respectively, by detection of delayed-type hypersensitivity, and scoring the antibody-forming cells in rat spleen induced by immunization with allogeneic erythrocytes. Primary, secondary and final products of lipid peroxidation were evaluated in lipid extracts from peripheral blood lymphocytes. Changes of immune state in CRF included depression of Th1 and Th2 dependent immune response, reduced number of lymphocytes bearing T and В cell markers, increased IL-1β concentrations in blood, along with decreased amounts of IFNγ and IL-4. Probable pathogenesis of the altered immune state may be associated with increased number of peripheral lymphocytes being at early and late stages of apoptosis/necrosis, elevated blood levels of IL-1β, total calcium, parathyroid hormone, reduced concentrations of IFNγ, and increased contents of primary, secondary and final peroxidation products in peripheral blood lymphocytes, being accompanied by inhibition of the SOD and catalase activity in blood plasma

  7. Uraemia from Benign Hypertension

    African Journals Online (AJOL)

    tance,' and the criteria for the recognition of malignant hypertension have become so well established that there is no dispute about the diagnosis when this condition ends in uraemia. By contrast, benign hypertension mani- fests itself mainly as cardiac or cerebrovascular disease,"" and although the occurrence of renal ...

  8. The Involvement of a Polyphenol-Rich Extract of Black Chokeberry in Oxidative Stress on Experimental Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Manuela Ciocoiu

    2013-01-01

    Full Text Available The aim of this study is to characterize the content of Aronia melanocarpa Elliott (black chokeberry extract and also to estimate the influence of polyphenolic compounds contained in chokeberries on oxidative stress, on an L-NAME-induced experimental model of arterial hypertension. The rat blood pressure values were recorded using a CODA Noninvasive Blood Pressure System. HPLC/DAD coupled with ElectroSpray Ionization-Mass Spectrometry allowed identification of five phenolic compounds in berries ethanolic extract as follows: chlorogenic acid, kuromanin, rutin, hyperoside, and quercetin. The serous activity of glutathione-peroxidase (GSH-Px has significantly lower values in the hypertensive (AHT group as compared to the group protected by polyphenols (AHT + P. The total antioxidant capacity (TAC values are lower in the AHT group and they are significantly higher in the AHT + P group. All the measured blood pressure components revealed a biostatistically significant blood pressure drop between the AHT group and the AHT + P group. The results reveal the normalization of the reduced glutathion (GSH concentration as well as a considerable reduction in the malondialdehyde (MDA serum concentration in the AHT + P group. Ethanolic extract of black chokeberry fruits not only has a potential value as a prophylactic agent but also may function as a nutritional supplement in the management of arterial hypertension.

  9. Renal effects of aliskiren compared with and in combination with irbesartan in patients with type 2 diabetes, hypertension, and albuminuria

    DEFF Research Database (Denmark)

    Persson, Frederik; Rossing, Peter; Reinhard, Henrik

    2009-01-01

    with type 2 diabetes, hypertension, and albuminuria (>100 mg/day) were randomly assigned to four 2-month treatment periods in random order with placebo, 300 mg aliskiren once daily, 300 mg irbesartan once daily, or the combination using identical doses. Patients received furosemide in a stable dose...... antiproteinuric in type 2 diabetic patients with albuminuria than monotherapy.......OBJECTIVE: We investigated whether the antiproteinuric effect of the direct renin inhibitor aliskiren is comparable to that of irbesartan and the effect of the combination. RESEARCH DESIGN AND METHODS: This was a double-blind, randomized, crossover trial. After a 1-month washout period, 26 patients...

  10. Failure to show decrease in small pulmonary blood vessels in rats with experimental pulmonary hypertension.

    OpenAIRE

    Kay, J M; Suyama, K L; Keane, P M

    1982-01-01

    We induced chronic pulmonary hypertension in one group of rats by exposing them to chronic hypobaric hypoxia (380 mm Hg for three weeks) and in another group by administering a single subcutaneous dose of monocrotaline (60 mg/kg body weight). Both groups of rats showed increase of the right ventricular mean systolic blood pressure and right ventricular hypertrophy. We measured the surface area of histological sections of the left or right lungs and counted all small blood vessels with an exte...

  11. Effect of traditional and integrative regimens on quality of life and early renal impairment in elderly patients with isolated systolic hypertension.

    Science.gov (United States)

    Li, Hao; Liu, Long-tao; Zhao, Wen-ming; Liu, Jian-gang; Yao, Ming-jiang; Han, Yong-xiang; Shen, Yan-peng; Liu, Xing-dong; Liu, Li; Wang, Xue-mei; Cai, Lin-lin; Guan, Jie

    2010-06-01

    To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension (EISH). A multi-center, randomized, double-blinded controlled trail was adopted. A total of 270 cases of EISH were randomly divided into 3 groups: Chinese medicine group (CM), combination group and Western medicine group (WM). The course of treatment was 4 weeks. The clinical blood pressure, integral of quality of life (SF-36 scale), immunoglubin G (IgG), microalbumin (mALB), beta(2)-microglobulin (beta(2)-MG), transferrin (TRF) and N-acetyl-beta'-D-glucosa-minidase (NAG) in urine were determined before and after the treatment. After treatment, systolic blood pressure depressed significantly in each group (P<0.05), and the combination group was superior to CM or WM group in depressing SBP (P<0.05); in each group, integral of quality of life improved in different degree, and combination group was superior to WM group in all 8 dimensions (P<0.05). The level of mALB and beta(2)-MG in urine decreased in all groups (P<0.05), and the combination group was superior to CM group or WM group in decreasing mALB (P<0.05). Chinese medical regimen has affirmative effect in treating EISH patients, and could lower the systolic blood pressure, improve quality of life and early renal impairment of the patients, and integrative medical regimen has superiority on account of cooperation, and deserves further study.

  12. Short-term effects of Ankaferd hemostat for renal artery embolization: an experimental study.

    Science.gov (United States)

    Ozbek, Orhan; Acar, Kadir; Koc, Osman; Saritas, Kadir; Toy, Hatice; Solak, Yalcin; Ozbek, Seda; Kucukapan, Ahmet; Guler, Ibrahim; Gaipov, Abduzhappar; Turk, Suleyman; Haznedaroglu, Ibrahim Celaleddin

    2013-04-01

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  13. Short-Term Effects of Ankaferd Hemostat for Renal Artery Embolization: An Experimental Study

    Energy Technology Data Exchange (ETDEWEB)

    Ozbek, Orhan, E-mail: orhan.ozbek@gmail.com [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Acar, Kadir [Selcuk University, Division of Hematology, Department of Internal Medicine, Meram School of Medicine (Turkey); Koc, Osman [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Saritas, Kadir [Afyon Kocatepe University, Department of General Surgery, Veterinary Faculty (Turkey); Toy, Hatice [Selcuk University, Department of Pathology, Meram School of Medicine (Turkey); Solak, Yalcin [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Ozbek, Seda [Selcuk University, Department of Radiology, Selcuklu School of Medicine (Turkey); Kucukapan, Ahmet; Guler, Ibrahim [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Gaipov, Abduzhappar; Turk, Suleyman [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Haznedaroglu, Ibrahim Celaleddin [Hacettepe University, Division of Hematology, Department of Internal Medicine, Faculty of Medicine (Turkey)

    2013-04-15

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  14. CHARACTERIZATION OF RENAL BLOOD FLOW REGULATION BASED ON WAVELET COEFFICIENTS

    DEFF Research Database (Denmark)

    Pavlov, A.N.; Pavlova, O.N.; Mosekilde, Erik

    2010-01-01

    . A reduction in the variability of the wavelet coefficients in hypertension is observed at both the microscopic level of the blood flow in efferent arterioles of individual nephrons and at the macroscopic level of the blood pressure in the main arteries. The reduction is manifest in both of the main frequency...... domains of nephron autoregulation and is likely to reflect a reduced flexibility of the cardiovascular system during hypertension.......The purpose of this study is to demonstrate the possibility of revealing new characteristic features of renal blood flow autoregulation in healthy and pathological states through the application of discrete wavelet transforms to experimental time series for normotensive and hypertensive rats...

  15. Hipertensión arterial como factor predictivo en pacientes con cáncer renal tratados con antiangiogénicos Hypertension as predictive factor in renal cell cancer treated with antiangiogenic therapy

    Directory of Open Access Journals (Sweden)

    Luciana Gennari

    2011-06-01

    Full Text Available El conocimiento de las diversas vías de oncogénesis ha llevado al desarrollo en los últimos cinco años de nuevas terapias para el tratamiento del cáncer renal avanzado, las que poseen como blanco al factor derivado del endotelio vascular (VEGF y sus receptores (antiangiogénicos y al blanco mamífero de la rapamicina (mTOR. Los antiangiogénicos constituyen un grupo de moléculas activas con un espectro de toxicidad peculiar que comprende el desarrollo de hipertensión arterial, disfunción tiroidea y síndrome de mano-pie. La identificación de factores predictivos clínicos y moleculares lograría identificar aquellos pacientes que se beneficiarían con dicho tratamiento, evitando exposición y toxicidad innecesaria al resto. La aparición de hipertensión arterial se ha correlacionado con respuesta al tratamiento y eficacia clínica. En nuestra serie retrospectiva, los pacientes tratados con antiangiogénicos que desarrollaron hipertensión arterial tuvieron aumento de la tasa de respuestas e intervalo libre de enfermedad en comparación con aquellos que, tratados de la misma manera, no manifestaron hipertensión. La hipertensión arterial debería considerarse como un factor predictor clínico en su tratamiento. Dichos hallazgos deberían ser corroborados en forma prospectiva y con un mayor número de pacientes.Knowledge of several pathways of oncogenesis has led to the development of novel therapies in the treatment of advanced kidney cancer in the last five years. These have targeted the vascular endothelium-derived factor (VEGF (angiogenesis and mammalian target of rapamycin (mTOR. Antiangiogenics are a group of active molecules with a peculiar spectrum of toxicity including the development of hypertension, thyroid dysfunction and hand-foot syndrome. The identification of molecular and clinical predictors would allow to identify those patients who would benefit from such treatment and saveguarding the rest from toxic exposure. The

  16. Renin-aldosterone-sodium profiling in hypertensive Filipinos. Pt. 2

    International Nuclear Information System (INIS)

    Guevara, R.; Torres, J. Jr; Abundo, H.P.; Perez, A.P.; Ochoa, W.K.

    1981-01-01

    Plasma renin activity determination by radioimmunoassay as profiling technique is a useful guide for more rational and precise treatment of hypertension. Statistical nomograms are developed for normals, essential hypertension, diabetic hypertension, renal diseases, renal disease and dialysis, normal pregnancy, toxemic pregnancy and contraceptive pill users with and without hypertension. (orig.) [de

  17. Effects of voluntary exercise on blood pressure, angiotensin II, aldosterone, and renal function in two-kidney, one-clip hypertensive rats

    Directory of Open Access Journals (Sweden)

    Waldman BM

    2017-11-01

    Full Text Available Brian M Waldman,1,2 Robert A Augustyniak,1–3 Haiping Chen,1,2 Noreen F Rossi1,2,4 1Department of Internal Medicine, 2Department of Physiology, Wayne State University School of Medicine, Detroit, MI, 3Department of Biomedical Sciences, Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, SC, 4Department of Internal Medicine, John D Dingell Veterans Administration Medical Center, Detroit, MI, USA Abstract: Spontaneous dynamic exercise promotes sympathoinhibition and decreases arterial pressure in two-kidney, one-clip (2K-1C hypertensive rats. Renal sympathetic nerves stimulate renin secretion and increase renal tubular sodium reabsorption. We hypothesized that daily voluntary wheel running exercise by 2K-1C rats will decrease mean arterial pressure (MAP, plasma angiotensin II (Ang II, and aldosterone as well as normalize urinary sodium and potassium excretion independent of changes in glomerular filtration rate (GFR. Five-week-old male Sprague Dawley rats underwent sham clipping (Sham or right renal artery clipping (2K-1C. Rats were randomized to standard caging (SED or cages with running wheels (EX. After 12 weeks, rats were assigned to either collection of aortic blood for measurement of Ang II and aldosterone or assessment of inulin clearances and excretory function. Running distances were comparable in both EX groups. MAP was lower in 2K-1C EX vs 2K-1C SED rats (P<0.05. Plasma Ang II and aldosterone were significantly higher in 2K-1C SED rats and decreased in 2K-1C EX rats to levels similar to Sham SED or Sham EX rats. Clipped kidney weights were significantly lower in both 2K-1C groups, but GFR and urine flow rates were no different from right and left kidneys among the four groups. Total and fractional sodium excretion rates from the unclipped kidney of 2K-1C SED rats were higher vs either Sham group (P<0.05. Values in 2K-1C EX rats were similar to the Sham groups. Potassium excretion paralleled sodium excretion. These

  18. Catheter-based induction of renal ischemia/reperfusion in swine: description of an experimental model.

    Science.gov (United States)

    Malagrino, Pamella A; Venturini, Gabriela; Yogi, Patrícia S; Dariolli, Rafael; Padilha, Kallyandra; Kiers, Bianca; Gois, Tamiris C; da Motta-Leal-Filho, Joaquim M; Takimura, Celso K; Girardi, Adriana C C; Carnevale, Francisco C; Zeri, Ana C M; Malheiros, Denise M A C; Krieger, José E; Pereira, Alexandre C

    2014-09-01

    Several techniques to induce renal ischemia have been proposed: clamp, PVA particles, and catheter-balloon. We report the development of a controlled, single-insult model of unilateral renal ischemia/reperfusion (I/R) without contralateral nephrectomy, using a suitable model, the pig. This is a balloon-catheter-based model using a percutaneous, interventional radiology procedure. One angioplasty balloon-catheter was placed into the right renal artery and inflated for 120 min and reperfusion over 24 h. Serial serums were sampled from the inferior vena cava and urine was directly sampled from the bladder throughout the experiment, and both kidneys were excised after 24 h of reperfusion. Analyses of renal structure and function were performed by hematoxylin-eosin/periodic Acid-Schiff, serum creatinine (SCr), blood urea nitrogen (BUN), fractional excretion of ions, and glucose, SDS-PAGE analysis of urinary proteins, and serum neutrophil gelatinase-associated lipocalin (NGAL). Total nitrated protein was quantified to characterize oxidative stress. Acute tubular necrosis (ATN) was identified in every animal, but only two animals showed levels of SCr above 150% of baseline values. As expected, I/R increased SCr and BUN. Fractional sodium, potassium, chloride, and bicarbonate excretion were modulated during ischemia. Serum-nitrated proteins and NGAL had two profiles: decreased with ischemia and increased after reperfusion. This decline was associated with increased protein excretion during ischemia and early reperfusion. Altogether, these data show that the renal I/R model can be performed by percutaneous approach in the swine model. This is a suitable translational model to study new early renal ischemic biomarkers and pathophysiological mechanisms in renal ischemia. © 2014 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  19. [Antihypertensive effect of arotinolol (S-596), a new adrenergic beta blocking agent, on experimental hypertension].

    Science.gov (United States)

    Hara, Y; Nakahara, H; Miyagishi, A; Nakatani, H

    1983-08-01

    Effects of a new adrenergic beta-blocking agent, arotinolol (S-596), on the blood pressure and heart rate were assessed in comparison with those of other beta-blocking agents in deoxycorticosterone acetate (DOCA)-saline induced and spontaneously hypertensive rats (SHR). The relationship between the antihypertensive effect and the beta- or alpha-adrenoceptor blocking action of S-596 was also investigated in normotensive conscious rats. In the rat, a cannula was implanted chronically in a femoral artery, from which blood pressure was recorded. The test drugs were administered orally once a day for 14 days at several dose levels. The development of hypertension in DOCA-saline treated rats was clearly retarded with the consecutive oral administration of propranolol (100 mg/kg/day) and hydrochlorothiazide (10 mg/kg/day), but not with S-596 (20, 50 and 100 mg/kg/day) or pindolol (10 mg/kg/day). On the other hand, in SHR, S-596 (more than 10 mg/kg/day) propranolol (50 mg/kg/day), pindolol (10 mg/kg/day), labetalol (100 mg/kg/day) and hydrochlorothiazide (10 mg/kg/day) produced definite antihypertensive effects after the chronic administration. In normotensive conscious rats, the vasodepressor responses induced by isoproterenol were reduced by the beta-blocking agents at lower dose levels than those required for development of antihypertensive effects. The acute effects on blood pressure were determined in hypertensive rats during the chronic treatment with the test drugs. In either type of hypertension, S-596, (10-50 mg/kg/day) showed a depressor effect at 4 and/or 8 hr after administration. In normotensive conscious rats, S-596 antagonized the pressor responses to phenylephrine at doses more than 30 mg/kg. It is therefore suggested that an adrenergic alpha-blocking property is at least partly involved in the hypotensive effect of S-596 as labetalol. In the experiment of acute effect in SHR, pindolol and labetalol showed prominent hypotensive effect after the 1st

  20. Tempol improves xanthine oxidoreductase-mediated vascular responses to nitrite in experimental renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Gustavo H. Oliveira-Paula

    2016-08-01

    Full Text Available Upregulation of xanthine oxidoreductase (XOR increases vascular reactive oxygen species (ROS levels and contributes to nitroso-redox imbalance. However, XOR can generate nitric oxide (NO from nitrite, and increased superoxide could inactivate NO formed from nitrite. This study tested the hypothesis that XOR contributes to the cardiovascular effects of nitrite in renovascular hypertension, and that treatment with the antioxidant tempol (4-hydroxy-2,2,6,6-tetramethylpiperidine-N-oxyl improves XOR-mediated effects of nitrite. Blood pressure was assessed weekly in two-kidney one-clip (2K1C and control rats. After six weeks of hypertension, the relaxing responses to nitrite were assessed in aortic rings in the presence of the XOR inhibitor oxypurinol (or vehicle, either in the absence or in the presence of tempol. Moreover, in vivo hypotensive responses to nitrite were also examined in the presence of oxypurinol (or vehicle and tempol (or vehicle. Aortic XOR activity and expression were evaluated by fluorescence and Western blot, respectively. Vascular ROS production was assessed by the dihydroethidium assay. 2K1C hypertensive rats showed increased aortic XOR activity and vascular ROS production compared with control rats. Oxypurinol shifted the nitrite concentration–response curve to the right in aortic rings from 2K1C rats (but not in controls. Oxypurinol also attenuated the hypotensive responses to nitrite in 2K1C rats (but not in controls. These functional findings agree with increased aortic and plasma XOR activity found in 2K1C rats. Tempol treatment enhanced oxypurinol-induced shift of the nitrite concentration–response curve to the right. However, antioxidant treatment did not affect XOR-mediated hypotensive effects of nitrite. Our results show that XOR is important to the cardiovascular responses to nitrite in 2K1C hypertension, and XOR inhibitors commonly used by patients may cancel this effect. This finding suggests that nitrite

  1. Tempol improves xanthine oxidoreductase-mediated vascular responses to nitrite in experimental renovascular hypertension.

    Science.gov (United States)

    Oliveira-Paula, Gustavo H; Pinheiro, Lucas C; Guimaraes, Danielle A; Tella, Sandra O Conde; Blanco, Ana L Furlan; Angelis, Celio D; Schechter, Alan N; Tanus-Santos, Jose E

    2016-08-01

    Upregulation of xanthine oxidoreductase (XOR) increases vascular reactive oxygen species (ROS) levels and contributes to nitroso-redox imbalance. However, XOR can generate nitric oxide (NO) from nitrite, and increased superoxide could inactivate NO formed from nitrite. This study tested the hypothesis that XOR contributes to the cardiovascular effects of nitrite in renovascular hypertension, and that treatment with the antioxidant tempol (4-hydroxy-2,2,6,6-tetramethylpiperidine-N-oxyl) improves XOR-mediated effects of nitrite. Blood pressure was assessed weekly in two-kidney one-clip (2K1C) and control rats. After six weeks of hypertension, the relaxing responses to nitrite were assessed in aortic rings in the presence of the XOR inhibitor oxypurinol (or vehicle), either in the absence or in the presence of tempol. Moreover, in vivo hypotensive responses to nitrite were also examined in the presence of oxypurinol (or vehicle) and tempol (or vehicle). Aortic XOR activity and expression were evaluated by fluorescence and Western blot, respectively. Vascular ROS production was assessed by the dihydroethidium assay. 2K1C hypertensive rats showed increased aortic XOR activity and vascular ROS production compared with control rats. Oxypurinol shifted the nitrite concentration-response curve to the right in aortic rings from 2K1C rats (but not in controls). Oxypurinol also attenuated the hypotensive responses to nitrite in 2K1C rats (but not in controls). These functional findings agree with increased aortic and plasma XOR activity found in 2K1C rats. Tempol treatment enhanced oxypurinol-induced shift of the nitrite concentration-response curve to the right. However, antioxidant treatment did not affect XOR-mediated hypotensive effects of nitrite. Our results show that XOR is important to the cardiovascular responses to nitrite in 2K1C hypertension, and XOR inhibitors commonly used by patients may cancel this effect. This finding suggests that nitrite treatment may not be

  2. Validation of an Experimental Model to Study Less Severe Chronic Renal Failure.

    Science.gov (United States)

    Fernandes-Charpiot, Ida Mária Maximina; Caldas, Heloisa Cristina; Mendes, Glória Elisa Florido; Gomes de Sá Neto, Luiz; Oliveira, Henrique Lacativa; Baptista, Maria Alice Sperto Ferreira; Abbud-Filho, Mario

    2016-10-01

    The 5/6 nephrectomy, mimics the stages of human chronic renal failure (CRF), but the procedure causes severe renal functional and morphological damage that could interfere with the evaluation of therapies for slowing the progression of the disease. This study summarizes the results of renal function, histology, and immunohistochemical findings in rats undergoing a 2/3 nephrectomy. The rats were distributed in groups according to the type of nephrectomy: CRF5/6: induced by a 5/6 renal mass reduction and CRF2/3: less severe CRF. The body weight and blood pressure were monitored, and the serum creatinine (SCr), creatinine clearance (CCr), urine osmolality, and 24-h proteinuria (PT24h) were measured. CRF progression was evaluated by the rate of decline of CCr (RCCr). Histology and immunohistochemistry were performed in the remnant kidneys. Statistical analysis was done by unpaired t-test, and a P-value renal histopathological findings revealed fewer chronic lesions in rats with CRF2/3. Similarly, we observed less macrophage accumulation as well as lower proliferative activity and expression of fibronectin and a-smooth muscle-actin in the CRF2/3 model. The CRF2/3 model presented with a pattern of less severe CRF, functionally and morphologically, compared to the classical CRF5/6 model, and the CRF2/3 model may be useful for evaluating therapeutic interventions that target the early stages of CRF.

  3. Lung vasodilatory response to inhaled iloprost in experimental pulmonary hypertension: amplification by different type phosphodiesterase inhibitors

    Directory of Open Access Journals (Sweden)

    Weissmann Norbert

    2005-07-01

    Full Text Available Abstract Inhaled prostanoids and phosphodiesterase (PDE inhibitors have been suggested for treatment of severe pulmonary hypertension. In catheterized rabbits with acute pulmonary hypertension induced by continuous infusion of the stable thromboxane analogue U46619, we asked whether sildenafil (PDE1/5/6 inhibitor, motapizone (PDE3 inhibitor or 8-Methoxymethyl-IBMX (PDE1 inhibitor synergize with inhaled iloprost. Inhalation of iloprost caused a transient pulmonary artery pressure decline, levelling off within per se ineffective dose of each PDE inhibitor (200 μg/kg × min 8-Methoxymethyl-IBMX, 1 μg/kg × min sildenafil, 5 μg/kg × min motapizone with subsequent iloprost nebulization, marked amplification of the prostanoid induced pulmonary vasodilatory response was noted and the area under the curve of PPA reduction was nearly threefold increased with all approaches, as compared to sole iloprost administration. Further amplification was achieved with the combination of inhaled iloprost with sildenafil plus motapizone, but not with sildenafil plus 8MM-IBMX. Systemic hemodynamics and gas exchange were not altered for all combinations. We conclude that co-administration of minute systemic doses of selective PDE inhibitors with inhaled iloprost markedly enhances and prolongs the pulmonary vasodilatory response to inhaled iloprost, with maintenance of pulmonary selectivity and ventilation perfusion matching. The prominent effect of sildenafil may be operative via both PDE1 and PDE5, and is further enhanced by co-application of a PDE3 inhibitor.

  4. Changes in kidney perfusion and renal cortex metabolism in septic shock: an experimental study.

    Science.gov (United States)

    Post, Emiel Hendrik; Su, Fuhong; Hosokawa, Koji; Taccone, Fabio Silvio; Herpain, Antoine; Creteur, Jacques; Vincent, Jean-Louis; De Backer, Daniel

    2017-01-01

    The etiology of renal dysfunction in sepsis is currently attributed to altered perfusion, microcirculatory abnormalities and cellular alterations. To clarify these mechanisms, we characterized the changes in renal perfusion and cortex metabolism in a large animal model of sepsis. We studied 12 adult female sheep randomized to peritonitis-induced sepsis (n = 8) or to sham procedure (n = 4). A flow probe was positioned around the renal artery to measure renal blood flow (RBF). Laser Doppler was used to measure regional flow in the kidney cortex and medulla. A microdialysis probe was inserted into the renal cortex to measure cortical glucose, lactate, and pyruvate. Fluid resuscitation was provided to keep pulmonary artery occlusion pressure at baseline levels. All animals were observed for 18 h. Hypotension occurred after 9 h in the septic animals (P = 0.02 versus baseline). RBF and cortical flow were significantly lower than at baseline from 12 h in the septic animals (P = 0.01 and P = 0.03, respectively). Cortical lactate and pyruvate levels increased in the septic animals from 3 and from 6 h, respectively (both P = 0.02 versus baseline), and the L/P ratio from 15 h (P = 0.01). There was a correlation between cortical flow and cortical L/P ratio after shock onset (r = -0.60, P = 0.002) but not before. In this peritonitis model, sepsis was associated with metabolic alterations that may reflect early induction of cortical glycolysis. Septic shock was associated with reduced renal perfusion and decreased cortical and medullary blood flow, followed by signs of anaerobic metabolism in the cortex when flow reductions became critical. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Impact of angiotensin and endothelin converting enzymes and related bradykinin on renal functions in L-NAME hypertensive rats

    Science.gov (United States)

    Omar, Ali Zainal; Maulood, Ismail M.

    2017-09-01

    The renin-angiotensin system (RAS), one of the most important hormonal systems, controls the kidney functions by regulating fluid volume, and electrolyte balance. The current study included the effects of kinin-kallikrein system (KKS) and its interaction with both angiotensin converting enzyme (ACE) and endothelin converting enzyme (ECE) on some of kidney function test parameters. In the present experiment, rats were divided into six groups, the first group was infused with normal saline, the second group was L-NG-Nitroarginine methyl ester (L-NAME) treated rats, third group was bradykinin (BK), forth group was captopril (ACEi), fifth group was phosphoramidon (ECEi), sixth group was a combination of BK with phosphoramidon. L-NAME was intravenously infused for one hour to develop systematic hypertension in male rats. After one hour of infusion, the results showed that L-NAME significantly increased serum creatinine. While, it decreased glomerular filtration rate (GFR), and K+ excretion rate. Moreover, BK increased packed cell volume PCV%, serum creatinine and K+ ion concentration. While, it reduced GFR, serum Ca+2 ion concentration, K+ and Na+ excretion rates. On the other hand, captopril infusion showed its effect by reduction in GFR, serum Ca+2 ion and electrolyte excretion rates. Phosphoramidon an ECEi dramatically reduced serum Ca+2 ion, but it increased pH, GFR and Ca+2 excretion rate. The results suggested that BK and Captopril each alone severely reduces GFR value. Interestingly, inhibition of ET-1 production via phosphoramidon could markedly elevate GFR values.

  6. Concurrent neutral endopeptidase and ACE inhibition in experimental heart failure: renal and hormonal effects

    DEFF Research Database (Denmark)

    Helin, K

    1993-01-01

    Neutral endopeptidase (NEP) inhibitors have been shown to strengthen the effects of endogenous atrial natriuretic peptide (ANP). It has been well documented that angiotensin I-converting enzyme (ACE) inhibitors act beneficially in chronic congestive heart failure (CHF). In the present study, renal...

  7. PARTIAL RENAL FUNCTIONS AND FLUID-AND-ELECTROLYTE BALANCE IN EXPERIMENTAL FLUOROSIS

    Directory of Open Access Journals (Sweden)

    Татьяна Константиновна Ядыкина

    2017-09-01

    Conclusions. The experiment showed that the prolonged exposure to sodium fluoride on the body was accompanied by the development of chronic nephropathy against the persistent disorders of the fluid-and-electrolyte balance and irreversible degenerative-dystrophic changes in the renal parenchyma.

  8. The efficacy and safety of dual blockage of the renin-angiotensin-aldosterone system in patients with type 2 diabetes, hypertension and obesity without renal dysfunction

    Directory of Open Access Journals (Sweden)

    S A Savelyeva

    2012-09-01

    Full Text Available The purpose of the study was to evaluate the clinical efficacy and safety of dual RAAS blockage during treatment with angiotensin-converting enzyme (ACE inhibitors in combination with a direct renin inhibitor (PIR aliskiren versus combination therapy with ACE inhibitors and angiotensin receptor blocker II (ARB valsartan in patients with type 2 diabetes mellitus (T2DM, arterial hypertension (AH and obesity, without renal dysfunction. Materials and methods. The study included 26 patients with T2DM (10 men and 16 women, mean age 59,0±6,2 years with inadequate control of blood pressure (over 130 and/or 80 mm Hg on prior antihypertensive therapy and without renal dysfunctions (glomerular filtration rate (GFR> 60 ml/min/1, 73 m2 and the of albumin/creatinine (A/C ratio in the morning urine sample <10 mg/mol. After screening with the continuation of the initial therapy, including ACE inhibitors, 14 patients were added aliskiren 150–300 mg/day, 12 patients – valsartan 80–160 mg/day. Evaluation of the treatment effectiveness in terms of blood pressure (mean of three consecutive measurements in the sitting position and the parameters of renal function (serum creatinine and potassium, GFR, A/C ratio in the urine was performed at 4, 12 and 24 weeks of therapy. Results. In the group of patients treated with aliskiren, after 4 weeks of treatment a significant decrease in systolic and diastolic blood pressure (SBP and DBP, respectively was noted as compared to baseline: 146,1 and 138,9 mm Hg, p<0,05, 87,1 and 81,1 mm Hg, p <0,05, respectively; with systolic BP after 24 weeks of treatment decreased to 127,8 (-18,2 mm Hg, p<0,05, diastolic BP to 75,0 (-12, 1 mm Hg, p<0,05, the target blood pressure (≤130/80 mm Hg was achieved in 83% of patients. The group of patients treated with valsartan, after 4 weeks of therapy showed a significant reduction in systolic BP 148 and 141,6 mm Hg, p <0,05, diastolic BP - to 85,8 and 81,7 mm Hg, p=0,059; after 24 weeks

  9. The effects of tadalafil on renal ischemia reperfusion injury: an experimental study

    Directory of Open Access Journals (Sweden)

    Feyzul Gasanov

    2011-08-01

    Full Text Available Many pharmacological agents were investigated for the prevention of renal ischemic reperfusion (I/R injury as well as the phosphodiesterase (PDE inhibitors. The aim of the study was to examine the possible renoprotective effect of a member in this family, tadalafil (Td on I/R injury. Thirty-six Spraque Dawley rats were allocated to six groups as; control, sham, ischemia (I, ischemia/reperfusion (I/R, Td pretreatment ischemia (Td/I and Td pretreatment ischemia/reperfusion (Td/IR groups. Right nephrectomy was performed in all groups. Td was dissolved in saline solution and given as a single dose (1mg/kg through an orogastrictube 60 min before the operation in the Td pretreatment groups. In ischemia group the left renal pedicle was occluded for 45 minutes and after than underwent left nephrectomy. In I/R group left renal pedicle was occluded for 45 minutes, reperfused for 1 hour and after then underwent nephrectomy. The left kidneys were evaluated after standard laboratory procedures with regard to tubular morphology, and leukocyte infiltration. The data were analyzed by using Kruskal–Wallis test to determine differences among the groups. A p value of < 0.05 was considered significant.Renal tubular damage was significant increased in the ischemia and I/R group (Groups III and IV when compared to those in the sham group (Group II, (p = 0.004, 0.004, respectively. Tubular damage, in the Td pretreatment ischemia (Td/I (Group V and Td pretreatment ischemia/reperfusion (Td/IR (Group VI were less than that in the ischemia group (Group III (p= 0.010, p= 0.025, respectively.Td administration prior to the renal I/R injury attenuated these morphological disarrangements, which were observed in renal I/R. Tubular necrosis, which may be considered as an important issue of the developing renal injury, was also completely prevented with Td administration.

  10. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...

  11. Peroxisome Proliferator-Activated Receptor-α Activation Decreases Mean Arterial Pressure, Plasma Interleukin-6, and COX-2 While Increasing Renal CYP4A Expression in an Acute Model of DOCA-Salt Hypertension

    Directory of Open Access Journals (Sweden)

    Dexter L. Lee

    2011-01-01

    Full Text Available Peroxisome proliferator-activated receptor-alpha (PPAR-α activation by fenofibrate reduces blood pressure and sodium retention during DOCA-salt hypertension. PPAR-α activation reduces the expression of inflammatory cytokines, such as interleukin-6 (IL-6. Fenofibrate also induces cytochrome P450 4A (CYP4A and increases 20-hydroxyeicosatetraenoic acid (20-HETE production. This study tested whether the administration of fenofibrate would reduce blood pressure by attenuating plasma IL-6 and renal expression of cyclooxygenase-2 (COX-2, while increasing expression of renal CYP4A during 7 days of DOCA-salt hypertension. We performed uni-nephrectomy on 12–14 week old male Swiss Webster mice and implanted biotelemetry devices in control, DOCA-salt (1.5 mg/g treated mice with or without fenofibrate (500 mg/kg/day in corn oil, intragastrically. Fenofibrate significantly decreased mean arterial pressure and plasma IL-6. In kidney homogenates, fenofibrate increased CYP4A and decreased COX-2 expression. There were no differences in renal cytochrome P450, family 2, subfamily c, polypeptide 23 (CYP2C23 and soluble expoxide hydrolase (sEH expression between the groups. Our results suggest that the blood pressure lowering effect of PPAR-α activation by fenofibrate involves the reduction of plasma IL-6 and COX-2, while increasing CYP4A expression during DOCA-salt hypertension. Our results may also suggest that PPAR-α activation protects the kidney against renal injury via decreased COX-2 expression.

  12. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  13. A Novel α-Calcitonin Gene-Related Peptide Analogue Protects Against End-Organ Damage in Experimental Hypertension, Cardiac Hypertrophy and Heart Failure

    DEFF Research Database (Denmark)

    Aubdool, Aisah A; Thakore, Pratish; Argunhan, Fulye

    2017-01-01

    was investigated over 14 days. Blood pressure was measured by radio-telemetry. The ability of the αAnalogue to modulate heart failure was studied in an abdominal aortic constriction (AAC) model of murine cardiac hypertrophy and heart failure over 5 weeks. Extensive ex vivo analysis was performed via RNA analysis......, Western blot and histology. Results -The AngII-induced hypertension was attenuated by co-treatment with the αAnalogue (50nmol/kg/day, s.c., at a dose selected for lack of long term hypotensive effects at baseline). The αAnalogue protected against vascular, renal and cardiac dysfunction, characterised...

  14. Propylthiouracil Attenuates Experimental Pulmonary Hypertension via Suppression of Pen-2, a Key Component of Gamma-Secretase.

    Directory of Open Access Journals (Sweden)

    Ying-Ju Lai

    Full Text Available Gamma-secretase-mediated Notch3 signaling is involved in smooth muscle cell (SMC hyper-activity and proliferation leading to pulmonary arterial hypertension (PAH. In addition, Propylthiouracil (PTU, beyond its anti-thyroid action, has suppressive effects on atherosclerosis and PAH. Here, we investigated the possible involvement of gamma-secretase-mediated Notch3 signaling in PTU-inhibited PAH. In rats with monocrotaline-induced PAH, PTU therapy improved pulmonary arterial hypertrophy and hemodynamics. In vitro, treatment of PASMCs from monocrotaline-treated rats with PTU inhibited their proliferation and migration. Immunocyto, histochemistry, and western blot showed that PTU treatment attenuated the activation of Notch3 signaling in PASMCs from monocrotaline-treated rats, which was mediated via inhibition of gamma-secretase expression especially its presenilin enhancer 2 (Pen-2 subunit. Furthermore, over-expression of Pen-2 in PASMCs from control rats increased the capacity of migration, whereas knockdown of Pen-2 with its respective siRNA in PASMCs from monocrotaline-treated rats had an opposite effect. Transfection of PASMCs from monocrotaline-treated rats with Pen-2 siRNA blocked the inhibitory effect of PTU on PASMC proliferation and migration, reflecting the crucial role of Pen-2 in PTU effect. We present a novel cell-signaling paradigm in which overexpression of Pen-2 is essential for experimental pulmonary arterial hypertension to promote motility and growth of smooth muscle cells. Propylthiouracil attenuates experimental PAH via suppression of the gamma-secretase-mediated Notch3 signaling especially its presenilin enhancer 2 (Pen-2 subunit. These findings provide a deep insight into the pathogenesis of PAH and a novel therapeutic strategy.

  15. Parameter estimation of feedback gain in a stochastic model of renal hemodynamics: differences between spontaneously hypertensive and Sprague-Dawley rats

    DEFF Research Database (Denmark)

    Ditlevsen, Susanne; Yip, Kay-Pong; Marsh, Donald J

    2006-01-01

    Proximal tubular pressure shows periodic self-sustained oscillations in normotensive rats but highly irregular fluctuations in spontaneously hypertensive rats (SHR). Although we have suggested that the irregular fluctuations in SHR represent low-dimensional deterministic chaos in tubuloglomerular...... mechanisms not included explicitly in the model. In its deterministic version, the model can have chaotic dynamics arising from TGF. The model introduces random fluctuations into a parameter that determines the gain of TGF. The model shows a rich variety of dynamics ranging from low-dimensional deterministic...... oscillations and chaos to high-dimensional random fluctuations. To fit the data from normotensive rats, the model must introduce only a small variation in the feedback gain, and its estimates of that gain agree well with experimental values. These results support the use of the deterministic model of nephron...

  16. Increased oxidative stress and severe arterial remodeling induced by permanent high-flow challenge in experimental pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Fadel Elie

    2011-09-01

    Full Text Available Abstract Background Involvement of inflammation in pulmonary hypertension (PH has previously been demonstrated and recently, immune-modulating dendritic cells (DCs infiltrating arterial lesions in patients suffering from idiopathic pulmonary arterial hypertension (IPAH and in experimental monocrotaline-induced PH have been reported. Occurrence of perivascular inflammatory cells could be linked to local increase of oxidative stress (OS, as it has been shown for systemic atherosclerosis. The impact of OS on vascular remodeling in PH is still to be determined. We hypothesized, that augmented blood-flow could increase OS and might thereby contribute to DC/inflammatory cell-recruitment and smooth-muscle-cell-proliferation. Methods We applied a monocrotaline-induced PH-model and combined it with permanent flow-challenge. Thirty Sprague-Dawley rats were assigned to following groups: control, monocrotaline-exposure (MCT, monocrotaline-exposure/pneumonectomy (MCT/PE. Results Hemodynamic exploration demonstrated most severe effects in MCT/PE, corresponding in histology to exuberant medial and adventitial remodeling of pulmonary muscular arteries, and intimal remodeling of smaller arterioles; lung-tissue PCR evidenced increased expression of DCs-specific fascin, CD68, proinflammatory cytokines (IL-6, RANTES, fractalkine in MCT/PE and to a lesser extent in MCT. Major OS enzyme NOX-4 was maximal in MCT/PE. Antioxidative stress enzymes Mn-SOD and glutathion-peroxidase-1 were significantly elevated, while HO-1 showed maximal expression in MCT with significant decrease in MCT/PE. Catalase was decreased in MCT and MCT/PE. Expression of NOX-4, but also of MN-SOD in MCT/PE was mainly attributed to a highly increased number of interstitial and perivascular CXCR4/SDF1 pathway-recruited mast-cells. Stress markers malonedialdehyde and nitrotyrosine were produced in endothelial cells, medial smooth muscle and perivascular leucocytes of hypertensive vasculature

  17. Increased oxidative stress and severe arterial remodeling induced by permanent high-flow challenge in experimental pulmonary hypertension.

    Science.gov (United States)

    Dorfmüller, Peter; Chaumais, Marie-Camille; Giannakouli, Maria; Durand-Gasselin, Ingrid; Raymond, Nicolas; Fadel, Elie; Mercier, Olaf; Charlotte, Frédéric; Montani, David; Simonneau, Gérald; Humbert, Marc; Perros, Frédéric

    2011-09-09

    Involvement of inflammation in pulmonary hypertension (PH) has previously been demonstrated and recently, immune-modulating dendritic cells (DCs) infiltrating arterial lesions in patients suffering from idiopathic pulmonary arterial hypertension (IPAH) and in experimental monocrotaline-induced PH have been reported. Occurrence of perivascular inflammatory cells could be linked to local increase of oxidative stress (OS), as it has been shown for systemic atherosclerosis. The impact of OS on vascular remodeling in PH is still to be determined. We hypothesized, that augmented blood-flow could increase OS and might thereby contribute to DC/inflammatory cell-recruitment and smooth-muscle-cell-proliferation. We applied a monocrotaline-induced PH-model and combined it with permanent flow-challenge. Thirty Sprague-Dawley rats were assigned to following groups: control, monocrotaline-exposure (MCT), monocrotaline-exposure/pneumonectomy (MCT/PE). Hemodynamic exploration demonstrated most severe effects in MCT/PE, corresponding in histology to exuberant medial and adventitial remodeling of pulmonary muscular arteries, and intimal remodeling of smaller arterioles; lung-tissue PCR evidenced increased expression of DCs-specific fascin, CD68, proinflammatory cytokines (IL-6, RANTES, fractalkine) in MCT/PE and to a lesser extent in MCT. Major OS enzyme NOX-4 was maximal in MCT/PE. Antioxidative stress enzymes Mn-SOD and glutathion-peroxidase-1 were significantly elevated, while HO-1 showed maximal expression in MCT with significant decrease in MCT/PE. Catalase was decreased in MCT and MCT/PE. Expression of NOX-4, but also of MN-SOD in MCT/PE was mainly attributed to a highly increased number of interstitial and perivascular CXCR4/SDF1 pathway-recruited mast-cells. Stress markers malonedialdehyde and nitrotyrosine were produced in endothelial cells, medial smooth muscle and perivascular leucocytes of hypertensive vasculature. Immunolabeling for OX62, CD68 and actin revealed

  18. Systolic hypertension in adult nigerians with hypertension

    International Nuclear Information System (INIS)

    Opadijo, O.G.; Salami, T.A.T.; Sanya, E.O.; Omotoso, A.B.O.

    2007-01-01

    To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Newly diagnosed adult hypertensives, with blood pressure 140/90mm Hg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ

  19. Renal dysfunction in African patients with acute heart failure

    NARCIS (Netherlands)

    Sani, Mahmoud U.; Davison, Beth A.; Cotter, Gad; Sliwa, Karen; Edwards, Christopher; Liu, Licette; Damasceno, Albertino; Mayosi, Bongani M.; Ogah, Okechukwu S.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike B.; Voors, Adrian A.

    Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive

  20. Alterations in Circulatory and Renal Angiotensin-Converting Enzyme and Angiotensin-Converting Enzyme 2 in Fetal Programmed Hypertension

    OpenAIRE

    Shaltout, Hossam A.; Figueroa, Jorge P.; Rose, James C.; Diz, Debra I.; Chappell, Mark C.

    2008-01-01

    Antenatal betamethasone treatment is a widely accepted therapy to accelerate lung development and improve survival in preterm infants. However, there are reports that infants who receive antenatal glucocorticoids exhibit higher systolic blood pressure in their early adolescent years. We have developed an experimental model of programming whereby the offspring of pregnant sheep administered clinically relevant doses of betamethasone exhibit elevated blood pressure. We tested the hypothesis as ...

  1. Manifestation of cystic fibrosis transmembrane regulator (CFTR) in hepatic ductal structures and renal tubules of female rats with experimental cholestasis of pregnancy.

    Science.gov (United States)

    Aleksandrova, M I; Kushnareva, N S; Smirnova, O V

    2014-03-01

    Studies by the immunohistochemical method with semiquantitative analysis of images showed that hyperprolactinemia stimulated CFTR protein manifestation in the bile ducts of female rats, which was clearly expressed in experimental cholestasis of pregnancy. The expression of CFTR in the renal tubules was reduced in hyperprolactinemia under conditions of normal liver function and in cholestasis of pregnancy. Significant positive correlations between CFTR, prolactin receptor, and multiple drug resistance protein 3 were detected in the bile ducts, but not in the renal tubules. Presumably, prolactin has a direct effect on CFTR expression in the bile ducts and indirect effect in the renal tubules. Changes in CFTR protein manifestation in the hepatic ductal structures and renal tubules in experimental pregnancy cholestasis could aggravate the disease.

  2. Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke: ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) Post Hoc Analysis.

    Science.gov (United States)

    Carr, Susan J; Wang, Xia; Olavarria, Veronica V; Lavados, Pablo M; Rodriguez, Jorge A; Kim, Jong S; Lee, Tsong-Hai; Lindley, Richard I; Pontes-Neto, Octavio M; Ricci, Stefano; Sato, Shoichiro; Sharma, Vijay K; Woodward, Mark; Chalmers, John; Anderson, Craig S; Robinson, Thompson G

    2017-09-01

    Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe RD (estimated glomerular filtration rate, 90 mL/min per 1.73 m 2 ), those with severe RD (stroke. There was no significant association with modified Rankin Scale scores 2 to 6 (adjusted odds ratio, 1.03; 95% confidence interval, 0.62-1.70; P =0.81 for trend), modified Rankin Scale 3 to 6 (adjusted odds ratio, 1.20; 95% confidence interval, 0.72-2.01; P =0.44 for trend), or symptomatic intracerebral hemorrhage, or any heterogeneity in comparative treatment effects between low-dose and standard-dose alteplase by RD grades. RD is associated with increased mortality but not disability or symptomatic intracerebral hemorrhage in thrombolysis-eligible and treated acute ischemic stroke patients. Uncertainty persists as to whether low-dose alteplase confers benefits over standard-dose alteplase in acute ischemic stroke patients with RD. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01422616. © 2017 American Heart Association, Inc.

  3. Pressure Measurement Techniques for Abdominal Hypertension: Conclusions from an Experimental Model.

    Science.gov (United States)

    Chopra, Sascha Santosh; Wolf, Stefan; Rohde, Veit; Freimann, Florian Baptist

    2015-01-01

    Introduction. Intra-abdominal pressure (IAP) measurement is an indispensable tool for the diagnosis of abdominal hypertension. Different techniques have been described in the literature and applied in the clinical setting. Methods. A porcine model was created to simulate an abdominal compartment syndrome ranging from baseline IAP to 30 mmHg. Three different measurement techniques were applied, comprising telemetric piezoresistive probes at two different sites (epigastric and pelvic) for direct pressure measurement and intragastric and intravesical probes for indirect measurement. Results. The mean difference between the invasive IAP measurements using telemetric pressure probes and the IVP measurements was -0.58 mmHg. The bias between the invasive IAP measurements and the IGP measurements was 3.8 mmHg. Compared to the realistic results of the intraperitoneal and intravesical measurements, the intragastric data showed a strong tendency towards decreased values. The hydrostatic character of the IAP was eliminated at high-pressure levels. Conclusion. We conclude that intragastric pressure measurement is potentially hazardous and might lead to inaccurately low intra-abdominal pressure values. This may result in missed diagnosis of elevated abdominal pressure or even ACS. The intravesical measurements showed the most accurate values during baseline pressure and both high-pressure plateaus.

  4. Constitutively active form of natriuretic peptide receptor 2 ameliorates experimental pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Nobutoshi Nawa

    2016-01-01

    Full Text Available We recently found a constitutively active mutant of natriuretic peptide receptor 2 (caNPR2; V883M, which synthesizes larger amounts of cyclic guanosine monophosphate (cGMP intracellularly without any ligand stimulation than existing drugs. The aim of this study was to investigate the therapeutic effects of gene transduction using caNPR2 for pulmonary arterial hypertension (PAH. In vitro gene transduction into human pulmonary arterial smooth muscle cells using Sendai virus (SeV vectors carrying caNPR2 induced 10,000-fold increases in the synthesis of cGMP without ligand stimulation, and the proliferation of caNPR2-expressing cells was significantly attenuated. The PAH model rats generated by hypoxia and the administration of SU5416 were then treated with SeV vectors through a direct injection into the left pulmonary artery. Right ventricular systolic pressure was significantly decreased 2 weeks after the treatment, while systemic blood pressure remained unchanged. Histological analyses revealed that the medial wall thickness and occlusion rate of pulmonary arterioles were significantly improved in caNPR2-treated lungs. Neither the systemic integration of virus vectors nor side effects were observed. The massive stimulation of cGMP synthesis by gene therapy with caNPR2 was safe and effective in a PAH rat model and, thus, has potential as a novel therapy for patients with severe progressive PAH.

  5. Renal artery stenosis.

    Science.gov (United States)

    Tafur-Soto, Jose David; White, Christopher J

    2015-02-01

    Atherosclerotic renal artery stenosis (RAS) is the single largest cause of secondary hypertension; it is associated with progressive renal insufficiency and causes cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy, including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid-lowering agents, and antiplatelet therapy, is advised in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe RAS are likely to benefit from renal artery revascularization. Screening for RAS can be done with Doppler ultrasonography, CT angiography, and magnetic resonance angiography. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Exploring the effect and mechanism of Hibiscus sabdariffa on urinary tract infection and experimental renal inflammation.

    Science.gov (United States)

    Chou, Shun-Ting; Lo, Hsin-Yi; Li, Chia-Cheng; Cheng, Lu-Chen; Chou, Pei-Chi; Lee, Yu-Chen; Ho, Tin-Yun; Hsiang, Chien-Yun

    2016-12-24

    Hibiscus sabdariffa Linn., also known as roselle, is used in folk medicine as an anti-inflammatory agent. Urinary tract infection (UTI) is a common problem in long-term care facilities. However, effects of roselle on UTI and renal inflammation remained to be analyzed. Here we surveyed the effect of roselle drink on the prevention of UTI in long-term care facilities and analyzed the anti-inflammatory potential of roselle on lipopolysaccharide (LPS)-induced renal inflammation in mice. Survey questionnaires and clinical observation were applied to evaluate the use of roselle and the incidence of UTI in long-term care facilities. Mice were administrated roselle orally for 7 consecutive days and then challenged with LPS. Anti-renal inflammatory effects of roselle were analyzed by microarray and immunohistochemical staining. Clinical observation showed that taking roselle drink in residents with urinary catheters reduced the incidence of UTI in long-term care facilities. Renal inflammation is a key event of UTI. Roselle suppressed LPS-induced nuclear factor-κB (NF-κB) activation in cells and LPS-induced interleukin-1β production in mice a dose-dependent manner. Immunohistochemical staining showed that roselle inhibited LPS-induced NF-κB activation and inflammatory cell infiltration in kidney. Gene expression profiling further showed that roselle suppressed the expression of pro-inflammatory cytokine genes and enzyme genes involved in the production of prostaglandin and nitric oxide. In addition, NF-κB was the main transcription factor involved in the regulation of roselle-regulated gene expression in kidney. This is the first report applying clinical observation-guided transcriptomic study to explore the application and mechanism of roselle on UTI. Our findings suggested that roselle drink ameliorated LPS-induced renal inflammation via downregulation of cytokine network, pro-inflammatory product production, and NF-κB pathway. Moreover, this report suggested the

  7. Hypertensive crisis in children.

    Science.gov (United States)

    Chandar, Jayanthi; Zilleruelo, Gastón

    2012-05-01

    Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

  8. Positive Captopril Renography Without Renal Artery Stenosis but a Renal Cell Carcinoma.

    Science.gov (United States)

    Hsieh, Ping-Ju; Kuo, Yen-Shu; Chen, Meng-Lin; Lin, Ching-Ling; Su, Hung-Yi

    2017-11-01

    A positive captopril renography indicates that patient's hypertension is renin dependent, most commonly caused by renal artery stenosis. The authors reported a case of positive captopril renography; however, CT demonstrated that renal arteries were intact, but there was a huge chromophobe renal cell carcinoma. Renin-dependent hypertension was relieved soon after nephrectomy. It is an uncommon cause of positive captopril renography.

  9. Colchicine Depolymerizes Microtubules, Increases Junctophilin-2, and Improves Right Ventricular Function in Experimental Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Prins, Kurt W; Tian, Lian; Wu, Danchen; Thenappan, Thenappan; Metzger, Joseph M; Archer, Stephen L

    2017-05-31

    Pulmonary arterial hypertension (PAH) is a lethal disease characterized by obstructive pulmonary vascular remodeling and right ventricular (RV) dysfunction. Although RV function predicts outcomes in PAH, mechanisms of RV dysfunction are poorly understood, and RV-targeted therapies are lacking. We hypothesized that in PAH, abnormal microtubular structure in RV cardiomyocytes impairs RV function by reducing junctophilin-2 (JPH2) expression, resulting in t-tubule derangements. Conversely, we assessed whether colchicine, a microtubule-depolymerizing agent, could increase JPH2 expression and enhance RV function in monocrotaline-induced PAH. Immunoblots, confocal microscopy, echocardiography, cardiac catheterization, and treadmill testing were used to examine colchicine's (0.5 mg/kg 3 times/week) effects on pulmonary hemodynamics, RV function, and functional capacity. Rats were treated with saline (n=28) or colchicine (n=24) for 3 weeks, beginning 1 week after monocrotaline (60 mg/kg, subcutaneous). In the monocrotaline RV, but not the left ventricle, microtubule density is increased, and JPH2 expression is reduced, with loss of t-tubule localization and t-tubule disarray. Colchicine reduces microtubule density, increases JPH2 expression, and improves t-tubule morphology in RV cardiomyocytes. Colchicine therapy diminishes RV hypertrophy, improves RV function, and enhances RV-pulmonary artery coupling. Colchicine reduces small pulmonary arteriolar thickness and improves pulmonary hemodynamics. Finally, colchicine increases exercise capacity. Monocrotaline-induced PAH causes RV-specific derangement of microtubules marked by reduction in JPH2 and t-tubule disarray. Colchicine reduces microtubule density, increases JPH2 expression, and improves both t-tubule architecture and RV function. Colchicine also reduces adverse pulmonary vascular remodeling. These results provide biological plausibility for a clinical trial to repurpose colchicine as a RV-directed therapy for PAH

  10. Croton schiedeanus Schltd prevents experimental hypertension in rats induced by nitric oxide deficit

    Directory of Open Access Journals (Sweden)

    María Teresa Páez

    2013-12-01

    Full Text Available Croton schiedeanus Schltd (N.V.: "almizclillo" is a plant used in traditional medicine as an antihypertensive in Colombia. It contains flavonoid, diterpenoid and fenilbutanoid metabolites that have vasodilatation effects linked to the NO/cGMP pathway. This work aimed to assess the capacity of a 96% EtOH extract to prevent the hypertension induced by nitric oxide (NO deficiency in rats. The NO synthase inhibitor L-NAME (10 mg/kg/d, i.p was administered during five weeks to three groups of rats (6-7 animals: C. Schiedeanus (200 mg/kg/d, p.o, enalapril (reference, 10 mg/kg/d, p.o and vehicle (control: olive oil 1 ml/kg/d, p.o. In addition, the blank group received only vehicle. The arterial blood pressure (BP and heart rate (HR were measured daily for six weeks. After sacrificing the animals, the aortic rings were isolated, contraction was triggered with phenylephrine (PE 10-6 M and relaxant responses were achieved with cumulative concentrations of acetylcholine (ACh, 10-10 - 10-4 M. L-NAME increased the systolic arterial pressure in the control group, attaining mean values of 131 mm Hg at week 5, whereas the C. schiedeanus, enalapril and blank groups maintained blood pressure under 100 mm Hg. The capacity of PE to contract aortic rings was greater in the C. schiedeanus, enalapril and blank groups than in the control group (2157, 2005, 1910 and 1646 mg, respectively. The pEC50 values for ACh were as follows: C. Schiedeanus (6.89 >enalapril (6.39 > blank (5.68 > control (5.09. These results give support to C. Schiedeanus as a natural antihypertensive source.

  11. Pan-PPAR agonist IVA337 is effective in experimental lung fibrosis and pulmonary hypertension.

    Science.gov (United States)

    Avouac, Jerome; Konstantinova, Irena; Guignabert, Christophe; Pezet, Sonia; Sadoine, Jeremy; Guilbert, Thomas; Cauvet, Anne; Tu, Ly; Luccarini, Jean-Michel; Junien, Jean-Louis; Broqua, Pierre; Allanore, Yannick

    2017-11-01

    To evaluate the antifibrotic effects of the pan-peroxisome proliferator-activated receptor (PPAR) agonist IVA337 in preclinical mouse models of pulmonary fibrosis and related pulmonary hypertension (PH). IVA337 has been evaluated in the mouse model of bleomycin-induced pulmonary fibrosis and in Fra-2 transgenic mice, this latter being characterised by non-specific interstitial pneumonia and severe vascular remodelling of pulmonary arteries leading to PH. Mice received two doses of IVA337 (30 mg/kg or 100 mg/kg) or vehicle administered by daily oral gavage up to 4 weeks. IVA337 demonstrated at a dose of 100 mg/kg a marked protection from the development of lung fibrosis in both mouse models compared with mice receiving 30 mg/kg of IVA337 or vehicle. Histological score was markedly reduced by 61% in the bleomycin model and by 50% in Fra-2 transgenic mice, and total lung hydroxyproline concentrations decreased by 28% and 48%, respectively, as compared with vehicle-treated mice. IVA337 at 100 mg/kg also significantly decreased levels of fibrogenic markers in lesional lungs of both mouse models. In addition, IVA337 substantially alleviated PH in Fra-2 transgenic mice by improving haemodynamic measurements and vascular remodelling. In primary human lung fibroblasts, IVA337 inhibited in a dose-dependent manner fibroblast to myofibroblasts transition induced by TGF-β and fibroblast proliferation mediated by PDGF. We demonstrate that treatment with 100 mg/kg IVA337 prevents lung fibrosis in two complementary animal models and substantially attenuates PH in the Fra-2 mouse model. These findings confirm that the pan-PPAR agonist IVA337 is an appealing therapeutic candidate for these cardiopulmonary involvements. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Development of Sustained Release "NanoFDC (Fixed Dose Combination" for Hypertension - An Experimental Study.

    Directory of Open Access Journals (Sweden)

    Anjuman Arora

    Full Text Available The present study was planned to formulate, characterize and evaluate the pharmacokinetics of a novel "NanoFDC" comprising three commonly prescribed anti-hypertensive drugs, hydrochlorothiazide (a diuretic, candesartan (ARB and amlodipine (a calcium channel blocker.The candidate drugs were loaded in Poly (DL-lactide-co-gycolide (PLGA by emulsion- diffusion-evaporation method. The formulations were evaluated for their size, morphology, drug loading and in vitro release individually. Single dose pharmacokinetic profiles of the nanoformulations alone and in combination, as a NanoFDC, were evaluated in Wistar rats.The candidate drugs encapsulated inside PLGA showed entrapment efficiencies ranging from 30%, 33.5% and 32% for hydrochlorothiazide, candesartan and amlodipine respectively. The nanoparticles ranged in size from 110 to 180 nm. In vitro release profile of the nanoformulation showed 100% release by day 6 in the physiological pH 7.4 set up with PBS (phosphate buffer saline and by day 4-5 in the intestinal pH 1.2 and 8.0 set up SGF (simulated gastric fluid and SIF (simulated intestinal fluid respectively. In pharmacokinetic analysis a sustained-release for 6 days and significant increase in the mean residence time (MRT, as compared to the respective free drugs was noted [MRT of amlodipine, hydrochlorothiazide and candesartan changed from 8.9 to 80.59 hours, 11 to 69.20 hours and 9 to 101.49 hours respectively].We have shown for the first time that encapsulating amlodipine, hydrochlorothiazide and candesartan into a single nanoformulation, to get the "NanoFDC (Fixed Dose Combination" is a feasible strategy which aims to decrease pill burden.

  13. Recent advances in the management of resistant hypertension

    OpenAIRE

    Manolis, Athanasios J.; Kallistratos, Manolis S.; Doumas, Michalis; Pagoni, Stamatina; Poulimenos, Leonidas

    2015-01-01

    And suddenly, following the preliminary results of renal denervation and carotid baroreceptor stimulation, a big interest in resistant hypertension rose, and all interventionists, many of them with no previous experience with hypertension, fell in love with hypertension and especially resistant hypertension. In the European Society of Hypertension/International Society of Hypertension (ESH/ISH) 2014 Joint Hypertension meeting in Athens, there were no more than four to five sessions related to...

  14. Assessing the impact of educational intervention in patients with hypertension.

    Science.gov (United States)

    Ho, Tai Mooi; Estrada, Dolors; Agudo, Josep; Arias, Piedad; Capillas, Raúl; Gibert, Elvira; Isnard, Mª Mar; Solé, Mª José; Salvadó, Anna

    2016-12-01

    It is accepted that patient education can be beneficial in the treatment of chronic diseases. We conducted an educational intervention (EI) in hypertensive patients seen at Primary Care centres (PCC) and specialised Hypertension Units (SHU). To assess patient's knowledge of hypertension and to verify the impact of this educational initiative. A multicentre quasi-experimental study with the participation of 120 patients with hypertension. EI consisted of oral and written information which included the definition of hypertension, causes, cardiovascular risk factors and means of control. A self-administered questionnaire was used to assess patient's knowledge before and after EI. Sixty-two (52%) patients were from PCC and 58 (48%) from SHU (mean age: 61 ± 13.3 years, 59% were women). There were no differences in baseline characteristics between patients attending at PCC and SHU. The definition of hypertension (blood pressure ≥140 mmHg and/or ≥90 mmHg was known by 48% and 99% of the participants before and after EI, respectively (p hypertension was related to kidneys (54%) and eyes (58%). After EI this knowledge increased to 100% (p hypertension. However, further studies are needed to assess if EI produces behaviour changes in the long term, as this might enhance optimal blood pressure control to prevent kidney disease or delay its progression. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  15. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephr......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  16. 4A.10: PREFERENTIAL REDUCTION IN MORNING/NOCTURNAL HYPERTENSION BY RENAL DENERVATION FOR DRUG- RESISTANT HYPERTENSION: A NEW ABPM ANALYSIS OF SYMPLICITY HTN-3 AND HTN-JAPAN.

    Science.gov (United States)

    Kario, K; Bakris, G L; Bhatt, D

    2015-06-01

    To study the impact of catheter-based renal artery denervation (RDN) on change in morning and night systolic BP (SBP) defined by ambulatory BP measurements (ABPM) 6 months post-randomization. SYMPLICITY HTN-3 and SYMPLICITY HTN-Japan are prospective, randomized, controlled trials of RDN for treatment of resistant hypertension. However, SYMPLICITY HTN-3 included a blinded, sham control and HTN-Japan control patients were not blinded and continued medical management alone. Patients in both trials were on a stable antihypertensive regimen of at least 3 drugs including a diuretic before randomization. Average morning SBP (7 am to 9 am), maximum morning SBP (between 6 am and 10 am), average nocturnal SBP (1 am to 6 am), average peak nocturnal SBP (average of 3 highest SBPs between 1 am and 6 am) and average daytime SBP were calculated using pooled patient-level ABPM data. Six-month change in SBP parameters were compared between RDN and control patients. A total of 386 patients (364 from HTN-3 and 22 from Japan) received RDN and 190 patients were in the control group (171 from HTN-3 and 19 from Japan). The average morning SBP was reduced -8.0 ± 22.3 mmHg in the RDN group which was significantly more than the change in the control group (-3.5 ± 22.2 mmHg, p = 0.023). The maximum morning SBP change was -8.6 ± 22.3 mmHg for RDN patients and -4.8 ± 23.8mmHg for controls (p = 0.072). Furthermore, the change in average nocturnal and average peak nocturnal SBP was significantly greater in the RDN patients compared with the control patients; -6.3 ± 18.1 vs -1.7 ± 19.2 mmHg, p = 0.008 for average nocturnal SBP and -6.7 ± 20.0 vs -1.3 ± 20.5 mmHg, p = 0.004 for average peak nocturnal SBP. Average daytime SBP change was not significantly between the RDN and control groups (-7.1 ± 16.0 vs -5.7 ± 18.0 mmHg, p = 0.349). This analysis demonstrated that RDN significantly reduced morning and nighttime SBP compared with

  17. Adaptation, allometry, and hypertension.

    Science.gov (United States)

    Weder, A B; Schork, N J

    1994-08-01

    Essential hypertension is a "disease of civilization" but has a clear genetic component. From an evolutionary perspective, persistence in the human genome of elements capable of raising blood pressure presupposes their adaptive significance. Recently, two hypotheses that explicitly appeal to selectionist arguments, the "slavery" and "thrifty gene" theories, have been forwarded. We find neither completely successful, and we advance an alternative explanation of the adaptive importance of genes responsible for hypertension. We propose that blood pressure rises during childhood and adolescence to subserve homeostatic needs of the organism. Specifically, we contend that blood pressure is a flexible element in the repertoire of renal homeostatic mechanisms serving to match renal function to growth. The effect of modern diet and lifestyle on human growth stimulates earlier and more vigorous development, straining biologically necessary relationships between renal and general somatic growth and requiring compensation via homeostatic mechanisms preserved during evolution. Prime among such mechanisms is blood pressure, which rises as a compensation to maintain renal function in the face of greater growth. Since virtually all members of acculturated societies share in the modern lifestyle, the demands imposed by accelerated growth and development result in a populational shift to higher blood pressures, with a consequent increase in the prevalence of hypertension. We propose that hypertension is the product of maladaptation of highly genetically conserved mechanisms subserving important biological homeostatic needs. Elucidation of the mechanisms underlying hypertension will require approaches that examine the developmental processes linking growth to blood pressure.

  18. An experimental study on renal damage induced by ionic contrast media in relation to iodine concentration

    International Nuclear Information System (INIS)

    Sung, Dong Wook; Yoon, Yup; Lim, Jae Hoon; Yang, Moon Ho

    1990-01-01

    Renal injury caused by iodinated contrast media has been widely known, but there has been few papers regarding the pathological change. A series of kidneys after injection of iodinated contrast media was examined to document pathological change. A total of 80 rats was divided into two groups; those given Urografin-60% by 5ml/kg; those given Urografin-76% by 5ml/kg. The kidneys were removed out 1, 2, 3, 5, 7, 10, 14 and 21 days after injection of contrast media and microscopically examined. The resulted were as follows: 1. Pathological changes induced by ionic contrast media were deposition of proteinaceous materials in the proximal convoluted tubules, congestion of interstitial vessels, and vasa rectae, and epithelial degeneration of collecting ducts. There was no detectable pathological changes in the glomerulus, loop of Henle, and distal convoluted tubules. 2. All pathological changes were severe, as the concentration of contrast media increased. 3. These pathologic changes appeared 1 day after injection of contrast media and persisted at least 3 weeks without improvement. Author concludes that the renal damage induced by ionic contrast media becomes severe with increase in concentration, and pathologic changes are not influence with time interval

  19. Experimental colitis is associated with transcriptional inhibition of Na+/Ca2+ exchanger isoform 1 (NCX1) expression by interferon γ in the renal distal convoluted tubules.

    Science.gov (United States)

    Radhakrishnan, Vijayababu M; Kojs, Pawel; Ramalingam, Rajalakshmy; Midura-Kiela, Monica T; Angeli, Peter; Kiela, Pawel R; Ghishan, Fayez K

    2015-04-03

    NCX1 is a Na(+)/Ca(2+) exchanger, which is believed to provide a key route for basolateral Ca(2+) efflux in the renal epithelia, thus contributing to renal Ca(2+) reabsorption. Altered mineral homeostasis, including intestinal and renal Ca(2+) transport may represent a significant component of the pathophysiology of the bone mineral density loss associated with Inflammatory Bowel Diseases (IBD). The objective of our research was to investigate the effects of TNBS and DSS colitis and related inflammatory mediators on renal Ncx1 expression. Colitis was associated with decreased renal Ncx1 expression, as examined by real-time RT-PCR, Western blotting, and immunofluorescence. In mIMCD3 cells, IFNγ significantly reduced Ncx1 mRNA and protein expression. Similar effects were observed in cells transiently transfected with a reporter construct bearing the promoter region of the kidney-specific Ncx1 gene. This inhibitory effect of IFNγ is mediated by STAT1 recruitment to the proximal promoter region of Ncx1. Further in vivo study with Stat1(-/-) mice confirmed that STAT1 is indeed required for the IFNγ mediated Ncx1 gene regulation. These results strongly support the hypothesis that impaired renal Ca(2+) handling occurs in experimental colitis. Negative regulation of NCX1- mediated renal Ca(2+) absorption by IFNγ may significantly contribute to the altered Ca(2+) homeostasis in IBD patients and to IBD-associated loss of bone mineral density. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  20. Resistant hypertension.

    Science.gov (United States)

    Armario, P; Oliveras, A; de la Sierra, A

    2013-11-01

    A 53 year old woman with hypercholesterolemia treated with statins, with no history of cardiovascular disease, was referred to the Hypertension and Vascular Risk Unit for management of hypertension resistant to 4 antihypertensive agents at full doses. The patient had obesity, with a body mass index of 36.3kg/m(2) and office blood pressure 162/102mm Hg. Physical examination showed no data of interest. glucose 120mg/dl, glycated Hb: 6.4%, albuminuria 68mg/g, kidney function and study of the renin angiotensin system and other biochemical parameters were normal. Echocardiography: left ventricular mass, 131g/m(2) (normal, <110g/m(2)). True resistant hypertension was confirmed by ambulatory monitoring of blood pressure during 24h (153/89mm Hg). Spironolactone treatment (25mg/day) was added and was well tolerated, with no change in renal function and kaliemia within normal (4.1mmol/l) following the treatment. After 8 weeks, blood pressure was well controlled: office blood pressure 132/86mm Hg and 24h-ambulatory blood pressure: 128/79mm Hg. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  1. Experimental basis of shockwave-induced renal trauma in the model of the canine kidney.

    Science.gov (United States)

    Rassweiler, J; Köhrmann, K U; Back, W; Fröhner, S; Raab, M; Weber, A; Kahmann, F; Marlinghaus, E; Jünemann, K P; Alken, P

    1993-01-01

    Using the new electromagnetic shockwave source of the Modulith SL 20 shockwave-induced renal trauma was evaluated by acute and chronic studies in the the canine kidney model. In a further study the electromagnetic shockwave source of the Lithostar Plus Overhead module was tested. Overall, 92 kidneys were exposed to shock waves coupled either by water bath (Modulith lab type) or by water cushion (Modulith prototype, Lithostar Overhead) under ultrasound localization. The generator voltage ranged between 11 and 21 kV, the number of impulses between 25 and 2500. After application of 1500/2500 shocks the extent of the renal lesion depended strictly on the applied generator voltage and was classified into 4 grades: Grade 0, no macroscopic trauma detectable (at 11-12 kV); grade 1, petechial medullary bleeding (at 13 kV); grade 2, cortical hematoma (at 14-16 kV); and grade 3, perirenal hematoma (17-20 kV). Whereas at low and medium energy levels the number of shocks played only a minor role, at maximal generator voltage (20 kV) even 25 impulses induced a grade 2 and 600 shocks a grade 3 lesion, emphasizing the importance of shockwave limitation in the upper energy range. In shockwave-induced renal trauma a vascular lesion was predominant and cellular necrosis was secondary. Coupling with a water cushion resulted in a 15%-20% decrease in the disintegrative and traumatic effect, which was compensated for by increasing the generator voltage by 2 kV. Long-term studies showed complete restitution following grade 1 and 2 trauma, whereas after a grade 3 lesion a small segmental and capsular fibrosis without hyperplasia of the juxtaglomerular apparatus was observed. Based on the characteristic ultrasound pattern found in the first study, the threshold for induction of grade 1 lesion was investigated. With both lithotripters a wide range for induction of a grade 1 lesion (Modulith 234-411, Lithostar Plus 220-740) and also a significant overlapping with grade 0 and 2 lesions was

  2. Radiologic evaluation of neonatal and childhood hypertension

    International Nuclear Information System (INIS)

    Amour, T.S.; Siegel, M.J.

    1986-01-01

    The authors reviewed the radiographic findings in 40 neonates and 90 children and adolescents with hypertension. In neonates the common causes of secondary hypertension were renal vascular thrombosis (33%), polycystic kidney disease (25%), and obstructive uropathy (17%). US and renal scans were the most useful studies and yielded diagnostic information in approximately 70% of cases. Surgically correctable hypertension was found in almost half the patients. In patients over 1 year of age, the common causes of hypertension were medical renal disease (50%) and renovascular hypetension (15%). Urography, scintigraphy, and arteriography played a crucial role in their evaluation

  3. Effects of propolis, caffeic acid phenethyl ester, and pollen on renal injury in hypertensive rat: An experimental and theoretical approach.

    Science.gov (United States)

    Salmas, Ramin Ekhteiari; Gulhan, Mehmet Fuat; Durdagi, Serdar; Sahna, Engin; Abdullah, Huda I; Selamoglu, Zeliha

    2017-08-01

    The objective of this study was to evaluate the antioxidant effects of propolis, caffeic acid phenethyl ester (CAPE; active compound in propolis), and pollen on biochemical oxidative stress biomarkers in rat kidney tissue inhibited by N ω -nitro-L-arginine methyl ester (L-NAME). The biomarkers evaluated were paraoxonase (PON1), oxidative stress index (OSI), total antioxidant status (TAS), total oxidant status (TOS), asymmetric dimethylarginine (ADMA), and nuclear factor kappa B (NF-κB). TAS levels and PON1 activity were significantly decreased in kidney tissue samples in the L-NAME-treated group (P propolis, CAPE, and pollen groups compared with the L-NAME-treated group. TOS, ADMA, and NF-κB levels were significantly increased in the kidney tissue samples of the L-NAME-treated group (P propolis, CAPE, and pollen groups (P propolis, CAPE administration. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation......) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  5. Long-term dietary L-arginine supplementation attenuates proteinuria and focal glomerulosclerosis in experimental chronic renal transplant failure

    NARCIS (Netherlands)

    Albrecht, EWJA; van Goor, H; Smit-van Oosten, A; Stegeman, CA

    Glomerular endothelial nitric oxide synthase expression is decreased in humans during acute rejection and chronic renal transplant failure (CRTF). This may contribute to vascular damage through changes in the renal hemodynamics and enhanced endothelial adhesion of leukocytes and platelets. Dietary

  6. Childhood hypertension: what does the radiologist contribute?

    International Nuclear Information System (INIS)

    Roebuck, Derek

    Hypertension may be essential (primary) or secondary to a variety of causes. The most important risk factors for essential hypertension are obesity and a family history of high BP, but there are also associations with sleep apnoea, low birth weight and prematurity. The most important cause of secondary hypertension in childhood is chronic renal disease. (orig.)

  7. Childhood hypertension: what does the radiologist contribute?

    Energy Technology Data Exchange (ETDEWEB)

    Roebuck, Derek [Great Ormond Street Hospital for Children NHS Trust, Radiology Department, London (United Kingdom)

    2008-06-15

    Hypertension may be essential (primary) or secondary to a variety of causes. The most important risk factors for essential hypertension are obesity and a family history of high BP, but there are also associations with sleep apnoea, low birth weight and prematurity. The most important cause of secondary hypertension in childhood is chronic renal disease. (orig.)

  8. The Potential Role of Catheter-Based Renal Sympathetic Denervation in Chronic and End-Stage Kidney Disease.

    Science.gov (United States)

    Sata, Yusuke; Schlaich, Markus P

    2016-07-01

    Sympathetic activation is a hallmark of chronic and end-stage renal disease and adversely affects cardiovascular prognosis. Hypertension is present in the vast majority of these patients and plays a key role in the progressive deterioration of renal function and the high rate of cardiovascular events in this patient cohort. Augmentation of renin release, tubular sodium reabsorption, and renal vascular resistance are direct consequences of efferent renal sympathetic nerve stimulation and the major components of neural regulation of renal function. Renal afferent nerve activity directly influences sympathetic outflow to the kidneys and other highly innervated organs involved in blood pressure control via hypothalamic integration. Renal denervation of the kidney has been shown to reduce blood pressure in many experimental models of hypertension. Targeting the renal nerves directly may therefore be specifically useful in patients with chronic and end-stage renal disease. In this review, we will discuss the potential role of catheter-based renal denervation in patients with impaired kidney function and also reflect on the potential impact on other cardiovascular conditions commonly associated with chronic kidney disease such as heart failure and arrhythmias. © The Author(s) 2016.

  9. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  10. Treatment-resistant hypertension and the incidence of cardiovascular disease and end-stage renal disease: results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

    Science.gov (United States)

    Muntner, Paul; Davis, Barry R; Cushman, William C; Bangalore, Sripal; Calhoun, David A; Pressel, Sara L; Black, Henry R; Kostis, John B; Probstfield, Jeffrey L; Whelton, Paul K; Rahman, Mahboob

    2014-11-01

    Apparent treatment-resistant hypertension (aTRH) is defined as uncontrolled hypertension despite the use of ≥3 antihypertensive medication classes or controlled hypertension while treated with ≥4 antihypertensive medication classes. Although a high prevalence of aTRH has been reported, few data are available on its association with cardiovascular and renal outcomes. We analyzed data on 14 684 Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants to determine the association between aTRH (n=1870) with coronary heart disease, stroke, all-cause mortality, heart failure, peripheral artery disease, and end-stage renal disease. We defined aTRH as blood pressure not at goal (systolic/diastolic blood pressure ≥140/90 mm Hg) while taking ≥3 classes of antihypertensive medication or taking ≥4 classes of antihypertensive medication with blood pressure at goal during the year 2 ALLHAT study visit (1996-2000). Use of a diuretic was not required to meet the definition of aTRH. Follow-up occurred through 2002. The multivariable adjusted hazard ratios (95% confidence intervals) comparing participants with versus without aTRH were as follows: coronary heart disease (1.44 [1.18-1.76]), stroke (1.57 [1.18-2.08]), all-cause mortality (1.30 [1.11-1.52]), heart failure (1.88 [1.52-2.34]), peripheral artery disease (1.23 [0.85-1.79]), and end-stage renal disease (1.95 [1.11-3.41]). aTRH was also associated with the pooled outcomes of combined coronary heart disease (hazard ratio, 1.47; 95% confidence interval, 1.26-1.71) and combined cardiovascular disease (hazard ratio, 1.46; 95% confidence interval, 1.29-1.64). These results demonstrate that aTRH increases the risk for cardiovascular disease and end-stage renal disease. Studies are needed to identify approaches to prevent aTRH and reduce risk for adverse outcomes among individuals with aTRH. © 2014 American Heart Association, Inc.

  11. Reduced KCNQ4-encoded voltage-dependent potassium channel activity underlies impaired ß-adrenoceptor-mediated relaxation of renal arteries in hypertension

    DEFF Research Database (Denmark)

    Chadha, Preet S; Zunke, Friederike; Zhu, Hai-Lei

    2012-01-01

    expression of KCNQ1, KCNQ3, KCNQ4, KCNQ5, and Kv7.1, Kv7.4, and Kv7.5 in rat renal artery. Isoproterenol produced concentration-dependent relaxation of precontracted renal arteries and increased Kv7 channel currents in isolated smooth muscle cells. Application of the Kv7 blocker linopirdine attenuated...

  12. Renal function in normal and potassium-depleted rats before and after preparation for micropuncture experimentation.

    Science.gov (United States)

    Shirley, D G; Zewde, T; Walter, S J

    1990-04-01

    Renal function was examined in unrestrained conscious rats maintained on either a control diet or a low-potassium diet, then re-examined in the same animals after thiobutabarbital (Inactin) anaesthesia and preparation for micropuncture studies. In conscious rats, insulin clearance (CIn) was not significantly different in the two groups (control 1012 +/- 43, low-K 904 +/- 58 microliters/min per 100g body wt; mean +/- SE), but lithium clearance (CLi; used as an estimate of end-proximal fluid delivery) and fractional lithium excretion (FELi) were substantially reduced in the low-K group (CLi: 246 +/- 11 vs 126 +/- 8 microliters/min per 100g body wt, P less than 0.001; FELi: 0.245 +/- 0.009 vs 0.143 +/- 0.008, P less than 0.001). Following anaesthesia and preparation for micropuncture, there were significant reductions in urine flow rate and sodium excretion in the control group, but not in the low-K rats. Potassium excretion increased in both groups, but values in the potassium-depleted animals remained extremely low. In neither group of rats was preparation for micropuncture associated with significant changes in CIn, CLi or FELi. Thus, differences in tubular function between control and potassium-depleted rats were still apparent. The results suggest that preparation for micropuncture disturbs the function of the distal nephron, but that rates of glomerular filtration and proximal tubular reabsorption remain similar to values in conscious animals.

  13. Contemporary treatment of renovascular hypertension

    Directory of Open Access Journals (Sweden)