Der Internist
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A genetic influence on blood pressure was demonstrated more than 100 years ago and a simple Mendelian inheritance was initially presumed. Platt and Pickering conducted a lively debate on this topic. Platt favored the idea that a single gene or only a few genes were responsible for high blood pressure. ⋯ A multitude of novel physiological mechanisms were explained by this. These findings will become therapeutically important. Therefore, it is incumbent upon clinicians to be optimally informed about these research results.
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Arterial hypertension along with a number of dietary risk factors top the global mortality statistics for noncommunicable diseases. The so-called Western diet and an increasingly sedentary lifestyle are partly responsible for the high prevalence of hypertension. ⋯ While extensive evidence has been generated in recent decades and guidelines emphasize healthier diets, implementation of dietary modifications remains a challenge in everyday clinical practice. Information and education as well as medical and nutritional support for patients can help to implement measures, such as weight and sodium restriction in the long term to improve the prognosis of patients with hypertension.
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Case Reports
[Persistent anemia after kidney transplantation in a 36-year-old male patient-an unusual cause].
An allogeneic kidney transplantation (match 1‑1‑0, cytomegalovirus, CMV, donor, D, +/recipient, R, - high risk) was performed in a 36-year-old patient. The patient was on dialysis due to a tubulointerstitial nephritis confirmed by biopsy 11 years previously. Posttransplantation there was a gradual decrease in the hemoglobin (Hb) level from 11.4 g/dl to 7.3 g/dl during the initial hospitalization period. ⋯ Despite repeated transfusion of red cell concentrates, a refractory anemia persisted, which is why the patient presented several times at our clinic for further diagnosis and treatment. The presence of giant erythroblasts in the bone marrow and quantitative detection of parvovirus B19 (>900 million IU/ml DNA replications) was consistent with a virus-associated red cell aplasia. Intravenous immunoglobulin administration was established and showed long-term therapeutic success.