Humans ; Renal Artery ; Constriction, Pathologic ; Hypertension, Renovascular/therapy* ; Vascular Diseases ; Renal Artery Obstruction/therapy* ; Embolization, Therapeutic

Renovascular hypertension is caused by narrowing of the arteries supplying the kidneys. There are several methods to treat renal artery stenosis, such as medications, percutaneous transluminal renal angioplasty, and atherosclerosis. A boy presented to our hospital with severe hypertension. Computed tomography angiogram revealed severe narrowing of the left renal artery and hypoplastic left kidney. Total renal artery embolizaton was performed to make a complete occlusion of the left renal artery. Follow-up renin and aldosterone levels were gradually decreased. The main advantage of renal artery embolization is that it is minimally invasive compared with extensive surgical procedures. Therefore, renal artery embolization should be considered as an alternative to surgical nephrectomy in pediatric patients with renovascular hypertension.
Child ; Embolization, Therapeutic/*methods ; Humans ; Hypertension, Renovascular/*therapy ; Male ; Renal Artery

No abstract available.
Adult ; Angiography, Digital Subtraction ; Angioplasty, Balloon ; *Blood Pressure ; Female ; Fibromuscular Dysplasia/*complications/diagnosis ; Humans ; Hypertension, Renovascular/diagnosis/*etiology/physiopathology/therapy ; Renal Artery Obstruction/diagnosis/*etiology/physiopathology/therapy ; Treatment Outcome

A technique based on release of the human atrial natriuretic peptide (hANP) from plasmid hANP cDNA transfected Chinese hamster ovary (CHO) cells encapsulated in polycaprolactone (PCL)-capsules was used for a potential therapeutic approach to hypertension or congestive heart failure (CHF). The plasmid combining with hANP cDNA was transfected into CHO cells, and then encapsulated plasmid hANP cDNA transfected CHO cells were implanted into two-kidney, one-clip (2K1C) hypertensive rats intraperitoneally. The morphological changes, histological changes were investigated after the implantation of PCL-capsules in 2K1C hypertensive rats. The results showed that the implantation of encapsulated hANP-producing cells caused a significant delay of blood pressure (BP) increase after the encapsulated cells being implanted in 2K1C hypertensive rats. These effects were reflected morphologically by an attenuation of the glomerular sclerotic lesions, tubular damage and renal arterial thickening, comparing with control group. The plasma levels of hANP in 2K1C rats implanted with the PCL-capsules containing hANP-producing cells were higher than that of the control rats. These results demonstrated the usefulness of encapsulated hANP gene transfected cells as a new tool for hANP gene delivery in studying renovascular hypertension and cardiovascular diseases, thus implying the potential of using gene transfected cells as therapeutic agents in the treatment of cardiovascular diseases.
Animals ; Atrial Natriuretic Factor ; biosynthesis ; genetics ; therapeutic use ; CHO Cells ; Capsules ; Cell Transplantation ; Cricetinae ; DNA, Complementary ; biosynthesis ; genetics ; Genetic Therapy ; methods ; Humans ; Hypertension, Renovascular ; pathology ; therapy ; Kidney ; pathology ; Male ; Plasmids ; Rats ; Rats, Wistar ; Recombination, Genetic ; Transfection ; Transgenes

OBJECTIVETo assess the value of renal vein renin , plasma endothelin (ET), nitric oxide (NO), calcitonin gene-related peptide (CGRP) in predicting the therapeutic effect of percutaneous renal artery stenting.

METHODSSelective renal angiography was performed in 60 patients with coronary artery disease and hypertension. All the patients with obvious unilateral renal artery stenosis (lumen narrowing >or =50%) underwent percutaneous transluminal renal angioplasty and stenting. Bilateral renal vein and inferior vena cava plasma renin activity (PRA) and plasma ET, NO, and CGRP levels were measured and the two-year follow-up data of the patients analyzed.

RESULTSIn all the patients, PRA in the ischemic kidney was significantly higher than that in the contralateral kidney (3.89-/+3.14 vs 2.01-/+1.93 nmol/L/h, P>0.05). After renal artery revascularization with stenting, PRA in the ischemic kidney was reduced obviously (P<0.05), which was significantly lower in patients with renal vein renin ratio (RVRR)>1.5 than in those with RVRR <1.5 (1.92-/+2.15 vs 2.42-/+0.56 nmol/L/h, P<0.05]. Plasma ET level was significantly higher, whereas plasma NO level significantly lower in patients with PVRR>1.5 (P<0.05). Greater improvement of blood pressure was observed in patients with RVRR>1.5 after two years than in those with RVRR< 1.5 (P<0.05).

CONCLUSIONThe activity of penal vein renin, plasma ET, NO, and CGRP may provide valuable information for predicting the therapeutic effect of percutaneous renal artery stenting.

Aged ; Angioplasty, Balloon ; methods ; Calcitonin Gene-Related Peptide ; blood ; Endothelin-1 ; blood ; Female ; Humans ; Hypertension, Renovascular ; blood ; therapy ; Male ; Middle Aged ; Nitric Oxide ; blood ; Radiography ; Renal Artery ; diagnostic imaging ; surgery ; Renal Artery Obstruction ; blood ; therapy ; Renal Veins ; Renin ; blood ; Stents

OBJECTIVETo evaluate the safety and efficacy of endovascular therapy for renal artery stenosis.

METHODSPercutaneous transluminal renal angioplasty with stent (PTRAS) was performed on 33 consecutive patients with severe renal artery stenosis who suffered from poorly controlled hypertension or renal dysfunction. They were subsequently underwent 7 to 49 months clinical follow up for the effect of the procedure on renal function, blood pressure control, mortality.

RESULTSAngiographic success was obtained in 32 (97.0%) of the 33 patients. The mortality was 18.2%. After PTRAS, two (6.1%) died of myocardial infarction within 4 months. Four (12.1%) patients with preoperative serum creatinine (Scr) > or = 177 micromol/L died of uraemia within 17 approximately 28 months. Twelve and twenty-four months after the procedure, systolic and diastolic blood pressure of 26 (78.8%) cases with preoperative Scr < 177 micromol/L significantly decreased (P < 0.05), with less antihypertensive medications taken and satisfactory renal function.

CONCLUSIONFor patients without serious cardiorenal disease, PTRAS has a beneficial effect on blood pressure and renal function. For patients with serious cardiorenal disease or preoperative Scr > or = 177 micromol/L, the mortality is higher. PTRAS should be performed prudently. The preservation of renal function may be enhance by using renal protection device.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; methods ; Female ; Follow-Up Studies ; Humans ; Hypertension, Renovascular ; etiology ; Male ; Middle Aged ; Renal Artery Obstruction ; complications ; therapy ; Renal Insufficiency ; etiology ; Stents ; Treatment Outcome

OBJECTIVETo observe the effect of Tiangou Jiangya capsule (TJC) on blood pressure in renovascular hypertension rats and explore its possible mechanism.

METHODSeventy-two Wistar rats were randomly divided into normal control group, model group, captopril group, TJC small, medium and high dose groups. Non-invasive blood pressure measurement was used to detect the arterial blood pressure of rat tails. PRA, Ang II , ALD, 6-Keto-PGF1alpha, ET and TXB2 content in blood was measured by radioimmunoassay. NO content in blood was determined by method of nitrate reductase.

RESULTThe systolic, diastolic and mean pressure significantly increased, serum PRA, Ang II , ALD decreased, ET levels significantly increased in model group rats. TJC significantly reduced blood pressure, improved the plasma renin activity, decreased ET levels and increased NO content of model rats.

CONCLUSIONTJC can reduce blood pressure of renovascular hypertention rats, and the mechanism may be related to its regulating lower blood pressure regulation of the secretion of RAAS system and improving vascular endothelial function.

Angiotensin II ; blood ; Animals ; Antihypertensive Agents ; administration & dosage ; pharmacology ; therapeutic use ; Benzyl Alcohols ; pharmacology ; therapeutic use ; Blood Pressure ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Flavonoids ; pharmacology ; therapeutic use ; Furans ; pharmacology ; therapeutic use ; Glucosides ; pharmacology ; therapeutic use ; Hypertension, Renovascular ; blood ; drug therapy ; Lignans ; pharmacology ; therapeutic use ; Rats ; Rats, Wistar ; Renin ; blood ; Renin-Angiotensin System ; drug effects

AIMTo observe the regression effect of tetrandrine (Tet) and enalapril (Ena) on vascular morphological changes in renovascular hypertensive (RH) rats.

METHODSRenovascular hypertension was induced by two kidney one clip (2K1C) operation. The morphometric measurements were performed in the aorta, caudal artery, renal arterioles, coronary arterioles and mesenteric arterioles.

RESULTSThe wet weight of aorta, caudal artery and femoral artery of RH rats (18 weeks after 2K1C operation) were greater than those of sham-operated rats. The media thickness, lumen diameter, cross section of media, media over lumen ratio and the wet weight of abdomen aorta, caudal artery, coronary arterioles, renal arterioles and mesenteric arterioles were significantly increased, which were more significant in arterioles with the diameter smaller than 70 microns. There were no significant change in the number of the smooth muscle cells (VSMC) in most vessel wall, except in renal arterioles, where the number of smooth muscle cells were significantly increased. After Tet (50 mg.kg-1.d-1, p.o.) or Ena (6 mg.kg-1.d-1, p.o.) treated for 9 weeks from week 9 after 2K1C operation, almost all the changes in the media thickness, the media to lumen ratio, the cross section of media and the wet weight were ameliorated.

CONCLUSIONIn RH rats, mainly a hypertrophic and rearrangement remodeling in the wall of arteries and arterioles was observed with a proliferation of VSMC in renal arterioles. Tet and Ena were shown to regress vascular remodeling by markedly attenuating these changes in renovascular hypertensive rats.

Alkaloids ; therapeutic use ; Animals ; Antihypertensive Agents ; therapeutic use ; Aorta, Abdominal ; pathology ; Arterioles ; drug effects ; pathology ; Benzylisoquinolines ; therapeutic use ; Blood Pressure ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; Enalapril ; therapeutic use ; Hypertension, Renovascular ; drug therapy ; pathology ; Kidney ; blood supply ; drug effects ; Male ; Muscle, Smooth, Vascular ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley

This experiment on rats was aimed to investigate the expression of intermedin (IMD) in hypertrophic cardiac myoctye of renal vascular hypertension induced by incomplete ligation of the left renal artery, and so to detect and compare the changes of the expression after administration of Valsartan, Amlodipine and Enalapril respectively. The criterion for standard modeling was systolic pressure > or = 140 mmHg. At 4 weeks after successful modeling, 60 SD male rats were randomly divided into 5 groups, namely the hypertrophy group, the 3 drug-treatment groups, and the sham-operation group as control. Blood pressure, left ventricular mass index (LVMI), and the left ventricular mean transverse diameter of myocardial cell (LVTDM) were investigated at the 10th week after model establishment. Gene expression of IMD mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR), and the optical density of the band was measured by use of the Gel Documentation System. The ratio of IMD mRNA to beta-actin mRNA was considered the relative amount of IMD. When compared with control, the blood pressure increased significantly in the hypertrophy group. There was no statistically significant difference between the treatment groups. No significant difference in heart rate was noted at 4 weeks after operation in all groups. LVMI and LVTDM levels were significantly higher in the hypertrophy group than in the other groups; LVMI and LVTDM levels showed no significant difference among the treatment groups but they were obviously higher than those of the Sham-operation group. The gene expression of IMD mRNA in the hypertrophy group was upregulated in the myocardium, when compared with that in the other groups. Meanwhile, although IMD mRNA in the treament groups was higher than that in the Sham-operation group, no statistically significant difference of myocardial IMD mRNA was found between the treament groups. These results suggested that, in this experiment, intracardiac IMD mRNA was upregulated and could participate in the regulation of cardiac remodeling in renal vascular hypertension-induced cardiac hypertrophy. This upregulation could improve the pathologic and physiologic process of cardiac hypertrophy, and could associate with the pressure loading or myocardia hypertrophy. However, the change did not display any difference that could be attributed to the variety of hypotensive drugs.
Adrenomedullin ; genetics ; metabolism ; Amlodipine ; therapeutic use ; Animals ; Antihypertensive Agents ; therapeutic use ; Cardiomegaly ; etiology ; metabolism ; Enalapril ; therapeutic use ; Hypertension, Renovascular ; complications ; drug therapy ; metabolism ; Male ; Myocardium ; metabolism ; Neuropeptides ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tetrazoles ; therapeutic use ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

OBJECTIVETo determine the protein expression of Calpain I, mRNA and protein expressions and activity of calcineurin, and the alternative splicing of Ca/calmodulin-dependent protein kinase II (CaMKII) δ in the hypertrophic heart, and to investigate the effect of angiotensin II type 1 receptor blocker valsartan (Val) on cardiac hypertrophy and the level of Calpain I, calcineurin and CaMKIIδ in renovascular hypertensive rats model.

METHODSRats were randomly divided into sham-operated control (n=8), hypertension (n=8) and hypertension plus Val (n=8, 30 mg×kg(-1)×(-1)). The renovascular hypertension was induced by two kidney-one clip methods in rats. The ratio of left ventricular weight to body weight was measured, the mRNA expression of calcineurin and alternative splicing of CaMKIIδ were determined by RT-PCR, the protein expression of Calpain I and calcineurin were measured by Western blot and the activity of calcineurin activity was assayed by a specialized kit.

RESULTSEight weeks after procedure, hypertension rats developed significantly cardiac hypertrophy, and the protein expression of Calpain I, mRNA and protein expression and the activity of calcineurin were significantly increased compared sham-operated control rats (all P<0.01), the mRNA expression of CaMKIIδA and B increased, CaMKIIδC mRNA decreased (P<0.01). Treatment with valsartan effectively attenuated cardiac hypertrophy and reversed hypertension induced changes on myocardial Calpain I, calcineurin and CaMKIIδ.

CONCLUSIONValsartan attenuates cardiac hypertrophy in renovascular hypertensive rats, possibly through inhibiting Calpain I, calcineurin and CaMKIIδ signaling pathways.

Animals ; Calcineurin ; metabolism ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; metabolism ; Calpain ; metabolism ; Hypertension, Renovascular ; drug therapy ; metabolism ; pathology ; Male ; Myocardium ; metabolism ; pathology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Tetrazoles ; pharmacology ; therapeutic use ; Valine ; analogs & derivatives ; pharmacology ; therapeutic use ; Valsartan