1/4. Embolization and angioplasty to relieve malignant hypertension and azotemia in a renal transplant patient.The case of a 23-year-old patient with malignant hypertension following a renal transplant illustrates the successful treatment of the hypertension with embolization of the native kidneys. azotemia followed and was successfully treated with percutaneous transluminal angioplasty of high-grade stenosis at the anastomotic site of the allograft. Malignant hypertension redeveloped with the recanalization of the embolized native kidneys. This was successfully treated with contrast ablation.- - - - - - - - - - ranking = 1keywords = azotemia (Clic here for more details about this article) |
2/4. Efficacy of captopril in relieving congestive heart failure developing during management of hypertension. Case report.A 20-year-old woman presented with malignant hypertension, pulmonary edema, anemia, and azotemia. blood pressure was adequately controlled only after progressively more intensive drug regimens, finally including minoxidil, nadolol, and furosemide. On these drugs, the patient developed progressive left and right heart failure, anasarca, and malnutrition. The control of hypertension, heart failure, and fluid retention, was accomplished by administration of captopril and furosemide. captopril is a logical alternative to vasodilators in refractory hypertension complicated by congestive heart failure.- - - - - - - - - - ranking = 0.25keywords = azotemia (Clic here for more details about this article) |
3/4. Development of malignant hypertension in patients with uremia under hemodialysis: a case report and discussions on its etiology.A woman, now 28 years old, was diagnosed 6 years ago as chronic glomerulonephritis by renal biopsy. From August 15, 1975 she complained of nausea, loss of appetite and weight (about 7 kg within 2 weeks). Severe hypertension (200/130 mmHg), hyponatremia (123 mEq/liter), anemia, elevated plasma renin activity (PRA), advanced azotemia, and eye ground changes of KW-II were found. dialysis treatment was started on September 2, 1975. From November 1975 massive amounts of sodium (5,000 mEq or more monthly) and water (26 liters or more monthly) were removed by the dialysis. These intensive dialyses resulted in an elevated PRA with recurrence of severe hypertension. At the end of March 1976 she became almost blind with retinopathy of KW-IV. Potent hypotensive drugs including beta-blockers were administered, but no improvements were obtained. On March 31, 1976 nephrectomy was performed to save her life. Marked hyalinization of glomeruli and heavy thickening of intima in interlobular arteries were found in the removed kidneys. renal artery stenosis was not recognized either macroscopically or histologically. In this patient, the amount of sodium removed by the dialysis was dependent on her diastolic blood pressure and sodium concentration of the dialysis. It may be concluded that too enthusiastic dialysis may develop malignant hypertension due to excessive renin release.- - - - - - - - - - ranking = 0.25keywords = azotemia (Clic here for more details about this article) |
4/4. Reversible malignant hypertension and azotemia due to urethral stricture.A previously normotensive 24-year-old black man developed malignant hypertension and azotemia. The patient was found to have bladder outlet obstruction due to urethral stricture. Transurethral dilation resulted in brisk improvement in renal function and rapid lowering of blood pressure in association with minimal diuresis. On follow-up one year later, while he was not receiving medications, the blood pressure was 120/70 mm Hg and the creatinine clearance was 150 ml/min. A kidney biopsy specimen showed minimal residual pathologic abnormalities in the renal arteries and arterioles. The renin-angiotensin system was probably involved in the maintenance of the hypertension, in view of the elevated peripheral plasma renin activity on admission. This represents a rare case of hypertension due to urethral stricture. Despite rapid progression to azotemic malignant hypertension, urethral dilation restored the blood pressure and renal function to normal.- - - - - - - - - - ranking = 1.25keywords = azotemia (Clic here for more details about this article) |