Limits...
Successful treatment of hypertension in anuric hemodialysis patients with a direct Renin inhibitor, aliskiren.

Maeda Y, Araki Y, Uno T, Nishigaki K, Inaba N - J Rural Med (2011)

Bottom Line: The averaged reduction of mean blood pressure was 4 ± 5 mmHg, and doses of antihypertensives other than aliskiren were reduced in 4 patients.Of the examined parameters, only the reduction rate of PRA x PAC seemed correlated with the BP lowering effect of aliskiren, which was calculated as the sum of the mean BP reduction in mmHg and drug reduction with 1 tablet (capsule)/day considered to be 10 mmHg.A DRI, aliskiren, was effective even in anuric dialysis patients, and monitoring of PRA and PAC was valuable for selecting cases responsive to aliskiren.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Japan.

ABSTRACT

Objective: A direct renin-inhibitor (DRI), aliskiren, was administered to anuric patients to investigate whether it can be a new optional therapy against hypertension in hemodialysis (HD) patients.

Patients: The patients that received aliskiren comprised 8 males and 2 females with a mean ± SD age of 63 ± 8 years (43-72 years). They were exposed to dialysis therapy for 118 ± 73 months (8-251 months), with diabetes mellitus in 4 cases, chronic glomerulonephritis in 4 cases, and other diagnoses in 2 cases.

Methods: After the plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured before an HD session, aliskiren, 150 mg as an initial dose, was administered to the patients. PRA and PAC were also examined a week after initiating aliskiren. The blood pressure (BP) levels at the start of each HD session for a period of 2 weeks (6 HD sessions) were compared between before and after administration of aliskiren. The change of doses in other antihypertensive agents was also counted.

Results: The averaged reduction of mean blood pressure was 4 ± 5 mmHg, and doses of antihypertensives other than aliskiren were reduced in 4 patients. Of the examined parameters, only the reduction rate of PRA x PAC seemed correlated with the BP lowering effect of aliskiren, which was calculated as the sum of the mean BP reduction in mmHg and drug reduction with 1 tablet (capsule)/day considered to be 10 mmHg.

Conclusion: A DRI, aliskiren, was effective even in anuric dialysis patients, and monitoring of PRA and PAC was valuable for selecting cases responsive to aliskiren.

No MeSH data available.


Related in: MedlinePlus

Effect of aliskiren on BP. Systolic, mean, and diastolic BP were averaged for beforeand after administration of aliskiren for 2 weeks (6 measurements before HD sessions).*: p < 0.05. **: p < 0.01.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4309347&req=5

fig_001: Effect of aliskiren on BP. Systolic, mean, and diastolic BP were averaged for beforeand after administration of aliskiren for 2 weeks (6 measurements before HD sessions).*: p < 0.05. **: p < 0.01.

Mentions: PRA and PAC before aliskiren treatment in each patient are described in Table 2. Administration of aliskiren to the ten anuric HD patientssignificantly suppressed the systolic, mean and diastolic BP before HD sessions (Figure 1Figure 1


Successful treatment of hypertension in anuric hemodialysis patients with a direct Renin inhibitor, aliskiren.

Maeda Y, Araki Y, Uno T, Nishigaki K, Inaba N - J Rural Med (2011)

Effect of aliskiren on BP. Systolic, mean, and diastolic BP were averaged for beforeand after administration of aliskiren for 2 weeks (6 measurements before HD sessions).*: p < 0.05. **: p < 0.01.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4309347&req=5

fig_001: Effect of aliskiren on BP. Systolic, mean, and diastolic BP were averaged for beforeand after administration of aliskiren for 2 weeks (6 measurements before HD sessions).*: p < 0.05. **: p < 0.01.
Mentions: PRA and PAC before aliskiren treatment in each patient are described in Table 2. Administration of aliskiren to the ten anuric HD patientssignificantly suppressed the systolic, mean and diastolic BP before HD sessions (Figure 1Figure 1

Bottom Line: The averaged reduction of mean blood pressure was 4 ± 5 mmHg, and doses of antihypertensives other than aliskiren were reduced in 4 patients.Of the examined parameters, only the reduction rate of PRA x PAC seemed correlated with the BP lowering effect of aliskiren, which was calculated as the sum of the mean BP reduction in mmHg and drug reduction with 1 tablet (capsule)/day considered to be 10 mmHg.A DRI, aliskiren, was effective even in anuric dialysis patients, and monitoring of PRA and PAC was valuable for selecting cases responsive to aliskiren.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Japan.

ABSTRACT

Objective: A direct renin-inhibitor (DRI), aliskiren, was administered to anuric patients to investigate whether it can be a new optional therapy against hypertension in hemodialysis (HD) patients.

Patients: The patients that received aliskiren comprised 8 males and 2 females with a mean ± SD age of 63 ± 8 years (43-72 years). They were exposed to dialysis therapy for 118 ± 73 months (8-251 months), with diabetes mellitus in 4 cases, chronic glomerulonephritis in 4 cases, and other diagnoses in 2 cases.

Methods: After the plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured before an HD session, aliskiren, 150 mg as an initial dose, was administered to the patients. PRA and PAC were also examined a week after initiating aliskiren. The blood pressure (BP) levels at the start of each HD session for a period of 2 weeks (6 HD sessions) were compared between before and after administration of aliskiren. The change of doses in other antihypertensive agents was also counted.

Results: The averaged reduction of mean blood pressure was 4 ± 5 mmHg, and doses of antihypertensives other than aliskiren were reduced in 4 patients. Of the examined parameters, only the reduction rate of PRA x PAC seemed correlated with the BP lowering effect of aliskiren, which was calculated as the sum of the mean BP reduction in mmHg and drug reduction with 1 tablet (capsule)/day considered to be 10 mmHg.

Conclusion: A DRI, aliskiren, was effective even in anuric dialysis patients, and monitoring of PRA and PAC was valuable for selecting cases responsive to aliskiren.

No MeSH data available.


Related in: MedlinePlus