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The evaluation of renin-angiotensin-aldosterone system blocking drugs use in hemodialysed patients
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Abstract
Material and methods The study was cross-sectional analysis of 102 hemodialysed patients, aged 28-86 years (mean 59 ± 13). We investigated the prevalence of RAA blocking drugs use in respect to symptoms of CHF, blood pressure, potassium concentration and dialysis adequacy.
Results Symptoms of CHF were found in 46 (45%) HD patients. RAA blocking drugs (angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) were taken by 46 (45%) HD patients; in 57% patients with CHF and in 36% HD patients without symptoms of CHF, respectively (p < 0.05). Potassium concentration was lower in CHF patients treated with ACEI//ARB compared with patients without CHF treated with ACEI/ARB (5.4 ± 0.6 vs. 6.0 ± 0.6 mmol/l; p < 0.01). Hyperkalaemia and low arterial pressure were main contraindications for ACEI/ARB use in HD patients.
Conclusions The study confirmed high prevalence of congestive heart failure symptoms in hemodialysed patients. ACEI/ARB use in HD patients with CHF is associated with lower risk of hyperkalaemia than in HD patients without CHF. Lack of clinical studies results in many questions regarding optimal therapy of CHF in HD patients unresolved. Arterial Hypertension 2007, vol. 11, no 4, pages 310-317.
Abstract
Material and methods The study was cross-sectional analysis of 102 hemodialysed patients, aged 28-86 years (mean 59 ± 13). We investigated the prevalence of RAA blocking drugs use in respect to symptoms of CHF, blood pressure, potassium concentration and dialysis adequacy.
Results Symptoms of CHF were found in 46 (45%) HD patients. RAA blocking drugs (angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) were taken by 46 (45%) HD patients; in 57% patients with CHF and in 36% HD patients without symptoms of CHF, respectively (p < 0.05). Potassium concentration was lower in CHF patients treated with ACEI//ARB compared with patients without CHF treated with ACEI/ARB (5.4 ± 0.6 vs. 6.0 ± 0.6 mmol/l; p < 0.01). Hyperkalaemia and low arterial pressure were main contraindications for ACEI/ARB use in HD patients.
Conclusions The study confirmed high prevalence of congestive heart failure symptoms in hemodialysed patients. ACEI/ARB use in HD patients with CHF is associated with lower risk of hyperkalaemia than in HD patients without CHF. Lack of clinical studies results in many questions regarding optimal therapy of CHF in HD patients unresolved. Arterial Hypertension 2007, vol. 11, no 4, pages 310-317.
Keywords
hemodialysis; heart failure; angiotensin converting enzyme inhibitors; potassium; renin-angiotensin-aldosterone system
Title
The evaluation of renin-angiotensin-aldosterone system blocking drugs use in hemodialysed patients
Journal
Issue
Article type
Original paper
Pages
310-317
Published online
2007-09-07
Page views
937
Article views/downloads
2231
Bibliographic record
Nadciśnienie tętnicze 2007;11(4):310-317.
Keywords
hemodialysis
heart failure
angiotensin converting enzyme inhibitors
potassium
renin-angiotensin-aldosterone system
Authors
Paweł Stróżecki
Mariusz Flisiński
Andrzej Brymora
Robert Kurowski
Witold Doroszewski
Grażyna Zarzycka-Lindner
Agnieszka Oręziak
Jacek Manitius