Hypertension and nephrology

[A Guidance to Authors]

SEPTEMBER 10, 2017

Hypertension and nephrology - 2017;21(04)

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Hypertension and nephrology

[Systemic ANCA-associated vasculitis. Induction immunosuppression therapy, complications and outcome. Part 2]

HARIS Ágnes, POLNER Kálmán

[The present review is compiled of two parts, the first part aims to summarize the induction immunosuppressive therapy, the second part delineates the outcome and complications of ANCA-associated vasculitis. ANCA-associated vasculitis is a systemic disease, accompanied with rapidly progressive glomerulonephritis and severe, often life-threatening extrarenal complications. By early diagnosis and immediate initiation of immunosuppressive therapy both patient and renal outcome have been substantially improved. The major aims of modern therapeutic protocols are, besides improving survival, to decrease immunosuppressive drug toxicity and avoid infections. Immunosuppression is based on the combination of large dose of corticosteroid and cyclophosphamide, which is advisable to supplement by plasma exchange. The B-cell depleting anti-CD20 monoclonal antibody rituximab, which has already been available in Hungary, has been proved to be similarly effective in newly diagnosed ANCA-vasculitis, and even more effective in a relapsing disease, compared to cyclophosphamide. Amongst rituximab’s further indications in this disease is the preservation of young women’s fertility, and it also has priority in some other special cases. Early diagnosis and prompt immunosuppressive treatment have resulted that ANCAvasculitis became a treatable disease with reasonably good clinical outcome, yet both the disease and the immunosuppressive medications frequently cause complications, which necessitate continuous alertness of the attending nephrologists.]

Hypertension and nephrology

[A Letter to Our Readers]

Hypertension and nephrology

[Isolated systolic hypertension in the elderly and very elderly]

FARSANG Csaba

[In the elderly (˃65 yrs) and very elderly (˃80 yrs) large clinical investigations showed that isolated systolic hypertension is the most frequent form of hypertension. In the background, several cardiovascular, neural and hormonal changes have been proved. One of the most important pathogenetic factor is the increase of arterial stiffness. This leads to the increase of pulse wave velocity and systolic blood pressure, and also to the decrease of diastolic blood pressure. Consequently, pulse pressure increases. All these factors contribute to the increase in incidence and prevalence of cardiovascular consequences of hypertension, which are more frequent than in younger ages.]

Hypertension and nephrology

[The Frequency of Isolated Systolic Hypertension in the Elderly among the Hungarian Hypertension Population ]

KISS István, PAKSY András, KÉKES Ede

Hypertension and nephrology

[Sex-specific clinical and exercise based risk assessment of the total mortality risk]

KÉKES Ede

[In both sexes combining different types clinical questionnaire and results of exercise test in a point system can more reliably predict 10 years mortality or survival. The method in both sexes is reliably suitable for the screening of highly endangered individuals in everyday practice.]

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