Hypertension and nephrology

[Growth trend of hyperuricaemia in our country between 2010–2014]

KÉKES Ede, BARNA István, DAIKI Tenno, DANKOVICS Gergely, KISS István

APRIL 20, 2015

Hypertension and nephrology - 2015;19(02)

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Hypertension and nephrology

[Fructose-induced hyperuricaemia]

NAGY Judit, KISS István, WITTMANN István, KOVÁCS Tibor

[The consumption of fructose and fructose-based sweeteners has dramatically increased in the last hundred years and correlates epidemiologically with the rising prevalence of obesity, hypertension and metabolic syndrome worldwide. The administration of fructose to animals and humans increases uric acid generation independently from excessive caloric intake. Fructose ingestion may also be a risk factor of chronic kidney disease, that includes glomerular hypertension, vascular alterations (arteriolosclerosis) and albuminuria. The discovery that fructose-mediated generation of uric acid may have a casual role in metabolic syndrome and kidney disease provides new insight into pathogenesis and therapies for these important diseases.]

Hypertension and nephrology

[DASH Diet on its Own or in Combination with Activity and Weight Loss: the Evaluation of Effectiveness in Non-Medicated Hypertension (Grade I) Patients on Blood Pressure and Cardiovascular Biomarkers: the ENCORE Study]

VÁRALLYAY Zoltán

Hypertension and nephrology

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

STUDINGER Péter, BARNA István

[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.]

Hypertension and nephrology

[Report on the 3rd Szeged Hypertension Day]

LÉGRÁDY Péter

Hypertension and nephrology

[Tubulointerstitial nephritis and uveitis syndrome]

BAJCSI Dóra, FEJES Imre, KEMÉNY Éva

[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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Hypertension and nephrology

[Serum uric acid in primary hypertension: cause or consequence? - Data from SEPHAR II Survey]

DOROBANTU Maria, TAUTU Oana-Florentina, BUZAS Roxana, LIGHEZAN Daniel

[Objectives: To evaluate a possible link between serum uric acid (SUA) levels, arterial stiffness and atherogenic index of plasma on one hand and renal function on the other and to test the role of SUA in the assessment of total cardiovascular risk. Materials and methods: We studied serum uric acid levels (SUA) in 1975 subjects included in SEPHAR II survey. We measured arterial stiffness parameters, calculated atherogenic index of plasma and estimated glomerular filtration rate (eGFR) by MDRD and CKD-EPI formulae and assessed total cardiovascular risk according to current ESH-ESC risk stratification chart. Results: The highest SUA values were recorded in subjects with grade III HT and were correlated with increased arterial stiffness and with increased atherogenic index of plasma. The lowest eGRF values, assessed by both MDRD and CKD-EPI, were observed among subjects with hyperuricemia and a significant indirect correlation between SUA and eGFR was evidenced. A proportional correlation between SUA values and total CV risk was also obtained. Conclusions: The study supports SUA implication in the pathogenesis of elevated blood pressure and the role of uric acid as a cardiovascular risk factor, particularly for the development of hypertension and renal disease.]

Hypertension and nephrology

[Prevalence of overweight and obesity in hypertensive patients]

KISS István, PAKSY András, KÉKES Ede

[Authors had performed an anthropometric analysis using a database of 2011-2013 of Hungarian Hypertension Register. They analyzed overweight and obesity in relation of age. The results were compared with similar analysis conducted in the total population 2015. They analyzed the prevalence of visceral obesity as well using the waist circumference measurement categories and these were also compared with screening data of total population. The prevalence of overweight and obesity was very high in both genders, co-occurrences exceeded 70% between 45-70 years. The prevalence was significantly higher in hypertensives, than in the total population. The prevalence of visceral obesity measured by waist circumference was also high, especially in women whose reached 50% of cases. They observed a significant difference between hypertensive and total populations In category „danger” of visceral obesity]

Hypertension and nephrology

[Serum uric acid level in hypertension. Domestic experience based on the data of the Hungarian Hypertonia Register 2011., 2013., 2015. Part I. Introduction. Patients and methods. Basic data]

KÉKES Ede, PAKSY András, ALFÖLDI Sándor

[Worldwide, screening in the general population detects an increase in serum uric acid levels in both sexes. This growth trend is also valid for hypertension. Authors studied the incidence of serum uric acid levels and its correlation with age, risk factors, anthropological, metabolic characteristics, blood pressure, blood pressure target, organ damage, age-related co-morbidity and drug therapy in 47,372 hypertensive patients (22,688 males, 24,684 women). In the first part of their analysis they present the method of analysis and the basic correlations. The uric acid level is higher in men than in women, with the advancement of age increasing. Increases in systolic and diastolic blood pressure are associated with increases in serum uric acid levels, with a tendency for systolic pressure to be significantly higher. For ladies, the rising trend is smaller and always lower in uric acid values. The uric acid value is higher in patients with the non-target blood pressure. The presence of co-morbidity significantly increases serum uric acid levels.]

Hypertension and nephrology

[Prevalence of isolated systolic hypertension in our country]

KÉKES Ede, BARNA István, DAIKI Tenno, DANKOVICS Gergely, KISS István

[Prevalence of hypertension over the age of 56 is increasing in size and a significant proportion (60-80%) of isolated systolic hypertension. Within the population screening in the older age groups - in the light of economic development - 25-40% of the prevalence. We have an opportunity to analyse the prevalence and specificity of isolated systolic hypertension from age 36 to age 10 years on the base of 7 years data of the MÁESZ (Comprehensive Health Protection Screening Program of Hungary 2010- 2020) survey. Between 56-65 years 23.27-24.23% (male/female) 66-75 years 34,89-33,15% and over 76 years 44.04-41.5% occurrence was found. Divergence of systolic and diastolic pressure has begun since 36 years. Pulse pressure was used to separate individuals with varying degree of vascular disorders.]