scholarly journals Relationship between Serum Elabela Level and Hypertensıve Nephropathy

2021 ◽  
Vol 31 (12) ◽  
pp. 1412-1416
Keyword(s):  
Hypertensive Nephropathy

Hypertensive Nephropathy and the Gene for Angiotensin-Converting Enzyme

1997 ◽  
Vol 17 (2) ◽  
pp. 252-256 ◽  
Author(s):  
Kazuomi Kario ◽  
Nobuyuki Kanai ◽  
Shinichi Nishiuma ◽  
Takeshi Fujii ◽  
Ken Saito ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Converting Enzyme ◽  
Hypertensive Nephropathy

scholarly journals More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens

2021 ◽  
Author(s):  
Johannes Philipp Kläger ◽  
Ahmad Al-Taleb ◽  
Mladen Pavlovic ◽  
Andrea Haitel ◽  
Eva Comperat ◽  
...  
Keyword(s):  
Interstitial Fibrosis ◽  
Renal Pathology ◽  
Vascular Lesions ◽  
Renal Tumors ◽  
Renal Diseases ◽  
Tumor Type ◽  
Neoplastic Tissue ◽  
Cell Renal Cell Carcinoma ◽  
Hypertensive Nephropathy ◽  
Tumor Nephrectomy

Abstract Background Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.

Kidney Biopsy in Type 2 Diabetes: A Multicenter Cross-Sectional Study

2021 ◽  
pp. 1-10
Author(s):  
Jonathan M. Chemouny ◽  
Mickaël Bobot ◽  
Aurélie Sannier ◽  
Valentin Maisons ◽  
Noémie Jourde-Chiche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Total Population ◽  
Cross Sectional Study ◽  
Rapid Progression ◽  
Hypertensive Nephropathy ◽  
Cross Sectional ◽  
Recent Onset ◽  
Atypical Features ◽  
Retinal Examination

<b><i>Introduction:</i></b> Kidney biopsies (KBs) are performed in patients with type 2 diabetes (T2D) to diagnose non-diabetic or hypertensive kidney disease (NDHKD) potentially requiring specific management compared to diabetic and or hypertensive nephropathy (absence of NDHKD). Indications for KB are based on the presence of atypical features compared to the typical course of diabetic nephropathy. In this study, we assessed the association of different patterns of atypical features, or KB indications, with NDHKD. <b><i>Methods:</i></b> Native KBs performed in patients with T2D were analyzed. Data were collected from the patients’ records. KB indications were determined according to the presence of different atypical features considered sequentially: (1) presence of any feature suggesting NDHKD which is not among the following ones, (2) recent onset of nephrotic syndrome, (3) low or rapidly declining estimated glomerular filtration rate (eGFR), (4) rapid increase in proteinuria, (5) short duration of diabetes, (6) presence of hematuria, or (7) normal retinal examination. <b><i>Results:</i></b> Among the 463 KBs analyzed, NDHKD was diagnosed in 40% of the total population and 54, 40, 24, and 7% of the KBs performed for indications 1–4 respectively. Conversely, no patient who underwent KB for indications 5–7 displayed NDHKD. Logistic regression analyses identified eGFR<sub>CKD-EPI</sub> &#x3e;15 mL/min/1.73 m<sup>2</sup>, urinary protein-to-Cr ratio &#x3c;0.3 g/mmol, hematuria, HbA1c &#x3c;7%, and diabetes duration &#x3c;5 years as predictors of NDHKD, independently from the indication group. <b><i>Conclusion:</i></b> NDHKD is frequent in T2D. Despite the association of hematuria with NDHKD, our results suggest that presence of hematuria and absence of DR are insufficient to indicate KB in the absence of concurrent atypical features. Conversely, rapid progression of proteinuria and rapid deterioration of eGFR are major signals of NDHKD.

FEATURES OF CHRONIC KIDNEY DISEASE IN ELDERLY PATIENTS

2020 ◽  
pp. 113-120
Author(s):  
О. Н. Курочкина
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Clinical Situation ◽  
Chronic Glomerulonephritis ◽  
Hypertensive Nephropathy ◽  
Number Of Patients ◽  
Rate Of Decline ◽  
People Group ◽  
Group 1

Изучены особенности течения хронической болезни почек (ХБП) у пожилых пациентов на основании анализа регистра ХБП за 2015-2018 гг. В регистре 484 пациента, из них 231 (47,7%) мужчина, 253 (52,3%) женщины, средний возраст - 58,8±15,8 года. Пациенты были разделены на три группы: 1-я - 218 человек до 59 лет; 2-я - 207 человек 60-74 лет; 3-я - 59 человек 75 лет и старше. В 1-й группе ведущей причиной ХБП явился хронический гломерулонефрит -27,1%, во 2-й - хронический тубулоинтерстициальный нефрит (ТИН) - 21,7%, диабетическая нефропатия (ДН) - 20,8% и гипертоническая нефропатия - 15,9%; в 3-й - ТИН (27,1%), хронический пиелонефрит (ПН) - 15,9% и ДН (13,6%). С возрастом увеличивалась частота встречаемости ТИН ( р <0,1), ПН ( р <0,05), ишемической болезни почек ( р <0,05), подагрической нефропатии ( р <0,1). Среднее снижение СКФ - 3,99 мл/мин на 1,73 мза год наблюдения. Темп снижения СКФ в 1-й группе - 3,36±1,8 мл/мин на 1,73 мза год, во 2-й - 2,43±1,2 ( р <0,001 между 1-йи 2-й группой), в 3-й - 1,82±1,1 мл/мин на 1,73 мза год. Наблюдали отрицательную корреляцию с возрастом ( р <0,05). Формирование регистра больных с ХБП позволяет знать количество больных и причины ХБП у пациентов пожилого и старческого возраста, оценивать клиническую ситуацию, темпы снижения СКФ и выбирать лечебную тактику у этих пациентов. The purpose of the work is to study the characteristics of the course of chronic kidney disease in elderly patients based on the analysis of the register of chronic kidney disease (CKD) for 2015-2018. in the Department of Nephrology, the Komi Republican Clinical Hospital. There are 484 patients in the register, of whom 231 are men (47,7%), 253 women (52,3%). The average age is 58,8±15,8 years old. The patients were divided into 3 groups: persons under the age of 59 years old - 218 people (group 1); from 60 to 74 years old - 207 people (group 2); and over 75 years old - 59 people (group 3). Most patients are between the ages of 60 and 69 years old. In the 1 group, the chronic glomerulonephritis is the leading cause of CKD - 27,1%; in the 2 group - the chronic tubulo-interstitial nephritis (TIN) - 21,7%, the diabetic nephropathy (DN) - 20,8% and the hypertensive nephropathy - 15,9%; in the 3 group - TIN (27,1%), the chronic pyelonephritis (PN) (15,9%) and DN (13,6%). With increasing age, the incidence of TIN ( p <0,1), MO ( p <0,05), coronary kidney disease (IBP) ( p <0,05), gouty nephropathy ( p <0,1) were raised. The average reduction in GFR is 3,99 ml/min/1,73 m per year of observation. The rate of decline in GFR in the 1st group is 3,36±1,8 ml/min/1,73 m per year, in the 2 - 2,43±1,2 ( p <0,001 between group 1 and 2), in the 3 group - 1,82±1,1; with aging the negative correlation was observed ( p <0,05). 39 patients received hemodialysis, including: in the 1 group - 20 people (9%), in the 2 group - 18 (8,7%), in the 3 group - 1 patient (1,7%). Making the register of the patients with CKD allows us to know the number of patients and the causes of CKD among the patients of elderly and senile ages, to assess the clinical situation, the rate of decline in GFR and treatment tactics in these patients.

scholarly journals Increased Renal Iron Accumulation in Hypertensive Nephropathy of Salt-Loaded Hypertensive Rats

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e75906 ◽  
Author(s):  
Yoshiro Naito ◽  
Hisashi Sawada ◽  
Makiko Oboshi ◽  
Aya Fujii ◽  
Shinichi Hirotani ◽  
...  
Keyword(s):  
Iron Accumulation ◽  
Hypertensive Rats ◽  
Hypertensive Nephropathy

scholarly journals Extracorporeal shock wave therapy does not improve hypertensive nephropathy

2016 ◽  
Vol 4 (11) ◽  
pp. e12699 ◽  
Author(s):  
Jonathan Caron ◽  
Pierre-Antoine Michel ◽  
Jean-Claude Dussaule ◽  
Christos Chatziantoniou ◽  
Pierre Ronco ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Hypertensive Nephropathy ◽  
Extracorporeal Shock Wave

scholarly journals SUN-196 Persistent Hyperkalemia After Unilateral Adrenalectomy for Aldosteronoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Hima Reddy Ammana ◽  
Susan Yuditskaya
Keyword(s):  
Adrenal Gland ◽  
Sodium Bicarbonate ◽  
Antihypertensive Agents ◽  
Kidney Dysfunction ◽  
Hypertensive Nephropathy ◽  
Unilateral Adrenalectomy ◽  
Post Surgery ◽  
Aldosterone To Renin Ratio ◽  
Potassium Binders ◽  
Patients Experience

Abstract Introduction Following unilateral adrenalectomy, some patients experience persistent hyperkalemia. This has been attributed to hypoaldosteronism due to severe suppression of aldosterone synthesis in the contralateral adrenal gland. Additionally, excess aldosterone leads to glomerular hyperfiltration masking kidney dysfunction, which can then manifest after cure with CKD-related hyperkalemia. Case Presentation We report a case of 51-year-old male who was diagnosed with hypertension in his late 30s. He required a beta-blocker and calcium channel blocker (CCB) for 10 years, and eventually developed hypertensive nephropathy. With worsening lower extremity edema, he was switched from a CCB to an angiotensin receptor blocker. Soon afterwards, he presented with hypertensive emergency and was discovered to have significant hypokalemia (K 2.1 mmol/L), prompting work up for primary aldosteronism. Biochemical evaluation revealed an elevated aldosterone to renin ratio of 38 [(ng/dL)/(ng/mL/hr)] and adrenal protocol CT scan revealed a 1.9 cm left adrenal nodule with benign characteristics. Adrenal vein sampling showed marked lateralization of excess aldosterone to the left adrenal gland, with proper catheter placement demonstrated in each adrenal veins (5-fold cortisol gradient bilaterally). He was started on spironolactone and 6 weeks later, underwent an uncomplicated laparoscopic left adrenalectomy. Spironolactone was discontinued Serum K level was normal at 4.8 mmol/L immediately postoperatively. Ten hours later, his K went up to 6.6 mmol/L which was confirmed by repeat blood work, accompanied by worsened renal function (Cr 2.5 mg/dL up from a of baseline 2.0). His hyperkalemia persisted in the 5.0 – 6.0 range despite IV Calcium Gluconate, Insulin and D50. Oral potassium binders were avoided due to concerns about ileus. Upon recognition of the possibility of hypoaldosteronism, we recommended a NaHCO3 gtt, with subsequent normalization of serum K. We avoided initiating fludrocortisone in the short term, due to uncertainty about duration of hypoaldosteronism, & because he was still requiring two antihypertensive agents. Plasma aldosterone 2 wks after surgery was fully suppressed, confirming suspicion of hypoaldosteronism. He has been managed successfully with oral sodium bicarbonate tablets, remaining normokalemic at 3 weeks post-surgery. Conclusion: Here we present a case of persistent hyperkalemia following resection of a signficantly biochemically active and long-standing aldosteronoma, which was successfully managed with sodium bicarbonate. We attribute the post-operative hyperkalemia in this patient to a combination of hypoaldosteronism due to deep suppression of the mineralocorticoid production of the contralateral adrenal, as well as unmasking of more severe kidney dysfunction than was he previously thought to have once aldosterone excess was withdrawn.

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