Renal-artery stenosis in a patient with Takayasu's arteritis

Renal‐artery stenosis is the basis of ischaemic nephropathy and is associated with renovascular hypertension. In patients with renal‐artery stenosis, acute renal failure may occur due to several reasons such as treatment with an angiotensin converting enzyme inhibitor or spontaneous progression of renal‐artery stenosis to occlusion [1]. In patients with a solitary kidney, occlusion of the renal artery causes anuric acute renal failure. Rapid diagnosis and treatment are the cornerstones of kidney survival. Following revascularization, the underlying cause of the renal‐artery occlusion has to be elucidated. We present a patient who had severe renal‐artery stenosis due to Takayasu's arteritis. In such patients, further diagnostic procedures are mandatory to diagnose the extent of the disease. Appropriate local and systemic therapy has to be initiated for other organ manifestations and to prevent recurrence of the disease

Low plasma volume coincides with sympathetic hyperactivity and reduced baroreflex sensitivity in formerly preeclamptic patients.

Contains fulltext : 50660.pdf (publisher's version ) (Open Access)BACKGROUND: Preeclampsia is associated with enhanced sympathetic activity as well as subnormal plasma volume. Meanwhile, in over 50% of these complicated pregnancies, the subnormal plasma volume has been found to persist for a prolonged period after pregnancy. The objective of this study is to test the hypothesis that in normotensive formerly-preeclamptic women, persistence of a subnormal plasma volume coincides with enhanced sympathetic activity and with it, an altered autonomic control of blood pressure. METHODS: Forty-eight formerly-preeclamptic women participated in this study. After measurement of their plasma volume by iodine 125-albumin indicator dilution, they were subdivided into a group with a normal plasma volume (plasma volume > 48 ml/kg lean body mass) and a group with a subnormal plasma volume (< or = 48 ml/kg lean body mass). We performed spectral analysis on their beat-to-beat blood pressure and heart rate recordings and compared both groups using non-parametric tests. RESULTS: Formerly-preeclamptic women with a subnormal plasma volume had a higher sympathetic activity (P = .001) and a lower baroreflex sensitivity (P = .04) than their counterparts with a normal plasma volume. CONCLUSION: In normotensive formerly-preeclamptic women, a subnormal plasma volume coincides with a higher sympathetic activity in the blood pressure regulation and lower baroreflex sensitivity. Whether these alterations in the autonomic control mechanisms are a cause or effect of the subnormal plasma volume remains to be elucidated