[Adult uveitis: apropos of 1 case with acute idiopathic interstitial nephritis]. / Uvéite chez l'adulte: à propos d'une observation avec néphrite interstitielle aiguë idiopathique.

The association of acute interstitial nephritis and uveitis is rare. In 1975, Dobrin reported a new syndrome in two children presenting acute interstitial nephritis, anterior uveitis and marrow-lymph node granulomas. We report one case of this association in the adult. A 35-year-old man was admitted to the hospital for acute renal failure, arthralgia and anterior uveitis. The infectious and the immunological investigations were negative. The ocular examination shows bilateral anterior uveitis. The renal biopsy revealed acute tubulo-interstitial nephritis. He was treated by prednisone (0.5 mg/Kg/day). His clinical course was favorable. Seven years later, the renal function is normal and we not observed a relapse of his uveitis.

Hypertension in primary chronic glomerulonephritis analysis of 359 cases.

The incidence of hypertension was evaluated in 359 patients with primary chronic glomerulonephritis who underwent renal biopsy. It was compared to a control group of 7,468 subjects who were obtained from an epidemiologic study performed in the same area at the same period. The prevalence of hypertension was 42%. On the basis of multiple regression analysis, the level of blood pressure was shown to be positively correlated to four independent variables: age, body mass index, degree of renal insufficiency and presence of proliferative glomerulonephritis. It was concluded that, although renal insufficiency increases the incidence of hypertension, proliferative lesions play an important contributive role in the development of hypertension.

Effect of alpha-methyldopa on cardiac output in hypertension.

Hemodynamic and blood volume changes, systolic time intervals, and baroreflex mechanisms were studied in 20 patients with hypertension after methyldopa (12 +/- 0.9 mg/kg/day). The drug was administered orally during 7 days' hospitalization on a normal sodium diet (110 mEq/day). There was a fall in blood pressure and in total peripheral resistance, without significant change in cardiac index, heart rate, and stroke index. There were increases in plasma and blood volume (p less than 0.05) but no change in cardiopulmonary blood volume or systolic time intervals. The unchanged heart rate was associated with an increased sensitivity ( less than 0.05) of the baroreflex mechanisms. The study supports the view that the unchanged cardiac output after methyldopa is related to important changes in control of cardiac output, including redistribution of blood volume and modifications in baroreflex mechanisms.

Arterial compliance in permanent essential hypertension: preliminary report.

Systemic arterial compliance was measured in 22 patients with permanent essential hypertension and compared with 11 sex- and age-matched normal normal subjects. Determinations were made from analysis of the monoexponential blood pressure-time curve during diastole, according to a simple visco-elastic model. Arterial compliance was significantly decreased (P less than 0.001) in hypertensives. In the overall population, arterial compliance was negatively correlated to age (P less than 0.005) and blood pressure (P less than 0.001), suggesting that the changes in compliance could be attributable to the level of blood pressure per se and/or to the rigidity of the arterial wall. Administration of vasoactive substances (angiotensin and sodium nitroprusside) enabled a strong negative relationship (P less than 0.01) between arterial compliance and diastolic blood pressure to be demonstrated in each individual. The slope of the curve was not dependent on age and represented the ability to decrease compliance per unit rise in pressure. The slope was steeper in hypertensives, suggesting a change reactivity of the arterial wall in these patients.