Uncontrollable hypertension in patients on hemodialysis: long-term treatment with captopril and salt subtraction

Details

Serval ID
serval:BIB_16D697683283
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Uncontrollable hypertension in patients on hemodialysis: long-term treatment with captopril and salt subtraction
Journal
Clinical Nephrology
Author(s)
Wauters  J. P., Waeber B., Brunner  H. R., Guignard  J. P., Turini  G. A., Gavras H.
ISSN
0301-0430
Publication state
Published
Issued date
1981
Peer-reviewed
Oui
Volume
16
Number
2
Pages
86-92
Language
english
Abstract
It has been suggested that an inappropriate relationship between renin and exchangeable sodium is responsible for the hypertension of patients with chronic renal failure. Long-term blockade of the renin system by captopril made it possible to test this hypothesis in 8 patients on maintenance hemodialysis. Captopril was administered orally in 2 daily doses of 25 to 200 mg. Previously, blood pressure averaged 179/105 +/- 6/3 (mean +/- SEM) pre- and 182/103 +/- 7/3 mm HG post-dialysis, despite intensive ultrafiltration and conventional antihypertensive therapy. The 4 patients with the highest plasma renin activity normalized their blood pressure with captopril alone, whereas in the 4 remaining patients, captopril therapy was complemented by salt subtraction which consisted in replacement of 1-2 liters of ultrafiltrate by an equal volume of 5% dextrose until blood pressure was controlled. After an average treatment period of 5 months, blood pressure of all 8 patients was reduced to 134/76 +/- 7/5 mm Hg (P less than 0.001) pre- and 144/81 +/- 9/5 mm Hg (P less than 0.001) post-dialysis without a significant change in body weight. The present data suggest that captopril alone or combined with salt subtraction normalizes blood pressure of patients on chronic hemodialysis with so called uncontrollable hypertension.
Keywords
AdolescentAdultAldosterone/bloodCaptopril/*therapeutic useChildClinical Trials as TopicFemaleHumansHypertension/*complications/metabolism/*therapyKidney Diseases/*therapyMaleMiddle AgedPeptidyl-Dipeptidase A/metabolismPlacebosProline/*analogs & derivativesRenal Dialysis/*methodsRenin/bloodSodium/blood
Pubmed
Web of science
Create date
04/03/2009 15:04
Last modification date
20/08/2019 12:46
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