Nefrite lupica: correlacao entre hipertensao insuficiencia arterial, renal e histologia renal. / Lupus nephritis: relationship between hypertension, arterial and renal failure and renal histology

Com o objetivo de se avaliar a relacao entre hipertensao arterial, insuficiencia renal e alteracoes histologicas dos rins, 51 pacientes com lupus eritematoso sistemico (LES) foram estudados. Tambem foram analisados nestes casos outros fatores que pudessem contribuir para ocorrencia de hipertensao. Hipertensao arterial ocorreu em 38% dos pacientes, sendo mais frequente naqueles com insuficiencia renal (P < 0,001). Estudo da histologia renal mostrou glomerulonefrite proliferativa difusa mais frequente entre os pacientes com hipertensao arterial (P < 0,05), enquanto que alteracoes histologicas minimas foram encontradas apenas em normotensos. Nao houve diferenca quanto a historia familiar de hipertensao, o uso de corticosteroides e a presenca de doencas associadas ao LES nos doentes com e sem hipertensao arterial

Metaischemic (post-Goldblatt) hypertensive vascular disease in rats.

Malignant hypertension was induced in rats by aortic ligation above the left renal artery. After 7- and 28-day periods of hypertension, the characteristics of the vascular disease were studied and the kidney below the aortic ligation was removed. The blood pressure and the vascular disease were reexamined at the end of the first and fourth weeks after nephrectomy. The evolution of the vascular disease was assessed in the contralateral kidney, in the heart, and in the superior mesentery. The results obtained allowed the following conclusions: 1) when the predominant lesions are of fibrinoid necrosis and moderate intimal hyperplasia without fibromucoid changes (initial phase), the hypertension and the hypertensive vascular disease are completely reversible after the nephrectomy; 2) when the predominant lesions are proliferative endarteritis with fibromucoid changes (chronic phase), neither the hypertension nor the vascular disease are reversible after the left nephrectomy and during the period of follow-up. Therefore, the type of vascular lesion seems to be one important determinant of the reversibility of the hypertensive process after nephrectomy.

Comparison between coronary and renal vessel lesions in the early phase of malignant hypertension in rats

A incidência de necrose fibrinóide artério-arteriolar foi 15 vezes maior nos vasos coronarianos do que nos vasos renais, na fase inicial da hipertensäo arterial malígna em ratos. Tal lesäo esteve presente no coraçäo de todos os animais hipertensos enquanto que esteve ausente no rim de 6 animais em um total de 8. Embora a doença vascular hipertensiva malígna envolva os diversos territórios vasculares, existe uma heterogeneidade no acometimento de diferntes órgäos. O modelo animal utilisado e o mecanismo fisiopatológico do processo hipertensivo podem ser importante em determinar tal diferença

Effects of sodium chloride on early and chronic phases of malignant hypertension in rats.

Malignant hypertension was induced in Sprague-Dawley rats by a complete aortic ligation above the left renal artery. The effects of saline (0.9% NaCl) administration on the development and course of the malignant hypertensive vascular disease were studied and the treated rats were compared to non-saline-treated animals and to sham-operated controls in the early and chronic phases of the disease. In the early phase, blood pressure, hematocrit, body weight, and hypertensive vascular disease were characteristic of the malignant hypertensive process and were without significant difference in saline- and non-saline-treated animals. In contrast, the sham-operated rats remained normotensive and did not present abnormal histological findings. Plasma renin activity although decreased in the hypertensive saline-treated animals was not suppressed. In the chronic phase, NaCl administration caused an average increase of 40 g body weight during the 1-wk period this solution was given, but did not result in any improvement in blood pressure levels and vascular disease in treated rats compared to non-saline-treated animals.

Tobramycin in chronic recurrent urinary tract infections.

A total of 32 adult patients of both sexes with chronic recurring urinary tract infections were treated with tobramycin in a daily dose of 1.2 mg/kg of body weight. They were randomly allocated to receive the drug at 8 or 12 hour intervals by intramuscular injection. The overall immediate disappearance of bacteriuria after therapy was 78.1 per cent; 15 days later, the cure rate dropped to 60 per cent. There was no difference between the two schedules tested. Tolerance to tobramycin was excellent. No reaction was recorded at the injection site; audiometry (performed in nine patients) and laboratory tests done prior to and after therapy did not reveal any hematologic, hepatic and/or renal toxicity, with one exception. In a patient with chronic renal failure (a patient with a solitary kidney infected with a pseudomonas sp.) there was a consistent elevation of blood urea in two separate courses of tobramycin, returning to normal within two weeks after stopping the therapy.

Estimation of renal hypertrophy: comparison of renal diameter, weight and volume.

The opposite kidney was studied 5-15 weeks after unilateral nephrectomy in groups of rats. The relative merits of weight, volume and diameter as parameters of renal hypertrophy were compared. Renal diameter was found to be a less sensitive index of renal hypertrophy than the other two parameters. Standard curves are presented which provide a suitable method for eliminating the influence of growth of the animal upon renal hypertrophy. This is particulary importan when animals of different weights are untilised.

Influence of regional factors in the distribution of the histologic patterns of glomerulopathies in the nephrotic syndrome.

Analysis of 47 renal biopsies performed on adult patients with nephrotic syndrome in Bahia, Brazil, shows a peculiar distribution of the histologic types with a preponderance of membranoproliferative glomerulonephritis. The possibility of a regional influence is discussed, particularly with regard to Schistosoma mansoni infection which is endemic in this area and probably an important cause of glomerulopathy.