Hypertension and nephrology

[Diagnosis of hypertension and target levels in mirror of the newest recommendations]

STUDINGER Péter, BARNA István

APRIL 20, 2015

Hypertension and nephrology - 2015;19(02)

[In the past year, many societies published new recommendations in the field of hypertension. The European Society of Hypertension and the European Society of Cardiology (ESH/ESC) published a comprehensive guideline in July 2013, providing an elaborate description of the diagnosis of hypertension. The clinical practice guideline of the American Society of Hypertension and the International Society of Hy per - tension (ASH/ISH) contains a brief set of recommendations, and explains the diagnostic approach to hypertension in a less detailed manner. The Eighth Joint National Committee (JNC8) focuses on certain aspects of hypertension using rigorous evidence- based methodology. This article displays some of the corresponding and disparate recommendations of the three guidelines.]

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Hypertension and nephrology

[Therapy of hypertension in mirror of the newest recommendations]

STUDINGER Péter, BARNA István

[Hypertension guidelines published by various societies in the previous year follow two distinct trends regarding recommendations about treatment. The European Society of Hypertension and the European Society of Cardiology (ESH/ESC) gives the clinician free hand to select the antihypertensive drug, mentioning the optimal treatment regime for various associated clinical conditions. Guidelines published by the American Society of Hypertension and the International Society of Hypertension (ASH/ISH) or by the Eighth Joint National Committee (JNC8) are far less permissive, recommend the first drug of choice from a narrower circle of antihypertensive agents and describe the initiation and escalation of therapy in algorithms. This article displays some of the corresponding and disparate recommendations of the three guidelines.]

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[Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare and underdiagnosed oculorenal disorder that is characterized by the development of acute tubulointerstitial nephritis and uveitis. The median age of onset is 15 years, but it may occur at any age. There is a female predominance. Uveitis might occur before, after, and also concomitantly with tubulointerstitial nephritis. The symptoms are typically non-specific, including fever, loss of appetite, weight loss, nausea and vomiting, weakness, abdominal pain, arthralgias and myalgias. Laboratory findings reveal an acute impairment of renal function, anaemia and elevated inflammatory parameters. Urinary findings are consistent with tubulointerstitial nephritis including subnephrotic proteinuria, sterile leucocyturia, microhaematuria, and tubular dysfunction (e.g. normoglycemic glycosuria). The prognosis appears to be good, especially in children. Persistent renal dysfunction only develops in a small proportion of cases. In this paper, we present the case of a 39-year-old female patient with TINU syndrome, and review the literature.]

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