Current opinion in nephrology and hypertension
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During the past 12 months additional evidence has emerged from observational studies indicating that high blood pressure is an important independent predictor of incident renal damage, progression of existing renal disease, and morbidity and mortality in patients with renal failure. Several of these studies suggest that elevation of systolic blood pressure is a stronger predictor of risk than a corresponding increase in diastolic blood pressure. ⋯ Ongoing trials should help clarify optimal choice of antihypertensive medications and goals for reduction of blood pressure in prevention of renal disease. In the interim, two new guidelines for management of hypertension in patients with existing renal disease provide helpful guidance for the clinician.
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Curr. Opin. Nephrol. Hypertens. · Jul 1994
ReviewCurrent understanding of severe preeclampsia, pregnancy-associated hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, hemolysis, elevated liver enzymes, and low platelet syndrome, and postpartum acute renal failure: different clinical syndromes or just different names?
Endothelial cell injury, with subsequent vasospasm, platelet activation, unbalanced prostacyclin-thromboxane ratio, and decreased release of endothelium-derived relaxing factor, play a central role in the pathogenesis of several disorders such as preeclampsia, hemolysis, elevated liver enzymes, and low platelet syndrome, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, acute fatty liver of pregnancy, and acute renal failure. It is possible that all these diseases are part of a spectrum of the same illness. ⋯ Differential diagnosis is often difficult due to the overlap of these syndromes. The purpose of this review is to clarify the differences and similarities among these pregnancy-related complications.
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Curr. Opin. Nephrol. Hypertens. · Jan 1994
Review Comparative StudyMolecular and cellular biology of vasopressin and oxytocin receptors and action in the kidney.
The molecular cloning and characterization of receptors for [Arg8] vasopressin and oxytocin were recently accomplished. These receptors form a subfamily among the large number of guanine nucleotide-binding regulatory protein (G protein)-coupled receptors with seven transmembrane domains. ⋯ Carrier detection and early diagnosis of affected male infants are available and can avert the physical and mental retardation that are the consequences of episodes of dehydration. Together with the recent cloning of the vasopressin-regulated water channels in the apical membrane of the collecting tubule, these developments will enable direct investigation of the mammalian concentrating mechanism.