ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

During the past decade, ambulatory blood pressure monitoring has risen rapidly as a diagnostic technique used in clinical research trials and, more recently, in clinical practice. Blood pressure monitors have become smaller, technologically improved, and quiet during recordings—all features that have increased patient compliance. During the past year, research has focused on establishing population norms for ambulatory blood pressure levels, improving methods of validating devices, enhancing our ability to reduce the ambulatory blood pressure data and provide clinically meaningful methods of statistical analysis, and evaluating the role of blood pressure monitoring in the management of hypertension in ambulatory care.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A variety of techniques have been used by different investigators to characterize blood pressure responses to changes in sodium balance. Despite the arbitrary nature of the definition of salt sensitivity, many of these studies have demonstrated consistency in the factors associated with the heterogeneous responses to the methods used. This review surveys current approaches to the assessment of blood pressure responsivity to alterations in sodium and extracellular fluid balance in normotensive as well as hypertensive humans. In addition, new observations related to the possible mechanisms involved are highlighted.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Many tests are available for the evaluation of renovascular hypertension; each of these has its own advantages and disadvantages as a screening test. The nonimaging tests include measurement of peripheral plasma renin activity, the captopril test, and renal vein renin sampling, all of which have inherent limitations. Screening tests also are available that provide more information as anatomic or physiologic images. Among the anatomic imaging methods, intravenous urography is the least accurate screening test, although it may provide other useful information. Magnetic resonance angiography may prove to be useful, although its use is limited by its high cost. The gold standard at present for diagnosing renal artery stenosis is contrast angiography, and improvements have been made using digital subtraction technology. However, its invasive nature and high cost do not warrant its routine use as a screening test in the evaluation of renovascular hypertension. Doppler sonography is a physiologic imaging test, and although it is limited because of its operator-dependent nature, it is most useful in the evaluation of patients with renal transplants. Captopril renal scintigraphy is another physiologic imaging test, and it has proven to be an excellent initial screening test that provides both diagnostic and prognostic information.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Renal calculus disease is a common cause of morbidity in industrialized societies, accounting for seven to 10 of every 1000 hospital admissions. Recent advances in surgical therapy have made operative therapy much less invasive while maintaining a high level of success. However, the need to reduce the incidence of this disease persists as more than one half of all stone formers will have recurrence. Although the etiology and therapy for several types of renal calculi are established, much remains unknown concerning the mechanisms of formation of the most prevalent form of renal calculi, calcium oxalate. This article reviews recent basic science and clinical research that attempts to identify the etiologies of renal calculus formation.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The histologic features of renal osteodystrophy vary from dialysis osteomalacia to osteitis fibrosa cystica. Commensurate with this, the number of osteoblasts and osteoclasts changes with the stage of the disease; the osteoblasts are virtually absent in dialysis osteomalacia and are numerous in osteitis fibrosa. Radiophosphate accretion in bone increases with increasing osteoblastic activity, and the bone mineral status is determined by the net difference in osteoblastic and osteoclastic activity. The application of radionuclide imaging and dual radiographic absorptiometry mineral measurements in patients with renal osteodystrophy, renal transplants, and following parathyroidectomy for secondary hyperparathyroidism is reviewed.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Proteinuria (protein excretion>300 mg/d) is an independent risk factor for the development of cardiovascular disease and renal failure. The finding of persistent proteinuria in otherwise asymptomatic patients often precedes the development of arterial hypertension and renal failure. When proteinuria is accompanied by arterial hypertension, blood pressure control can decrease the quantity of protein excretion but not the incidence of proteinuria. In this sense, converting enzyme inhibitors seem to possess a higher capacity to reduce proteinuria. Nevertheless, the effects of reducing proteinuria on renal function and cardiovascular risk remain to be elucidated. Microalbuminuria (urine albumin excretion oscillating between 30 and 300 mg/d) seems to be a predictor of cardiovascular disease in diabetic and nondiabetic subjects and has been established as a predictor for the development of diabetic nephropathy. Blood pressure levels and urinary albumin excretion correlate positively, and antihypertensive therapy of any kind decreases the quantity of albumin present in the urine. The role of increased albumin excretion in essential hypertension and in renal failure remains to be elucidated.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Percutaneous renal biopsy provides the cornerstone for our understanding of the diseases of the kidney. Recent advances in biopsy techniques, such as the use of real-time ultrasonography and the biopsy gun, have made this procedure easier, increased the yield of diagnostically adequate tissue, and may result in a lower complication rate as well. Despite these improvements, the role of biopsy in the treatment of individual patients remains controversial. Even in diseases such as nephrotic syndrome and systemic lupus erythematosus, where biopsy findings have been used to categorize outcome events, it is unclear whether the biopsy provides more accurate information than can be obtained from less invasive procedures or from empiric therapy. Renal biopsy, however, does remain the best method for evaluation of renal dysfunction in renal allograft recipients. The role of fine-needle aspiration cytology in the management of transplant rejection remains to be established.

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:1993

数据来源: OVID