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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

Reduction rate of (PRA × PAC) and the score for the BP lowering effect. These valueswere not significantly correlated (Y = 0.12X – 0.78, r = 0.44, p = 0.20), but high BPlowering effects (score > 5) were observed only in the cases showing a high percentreduction rate (> 80%).
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fig_004: Reduction rate of (PRA × PAC) and the score for the BP lowering effect. These valueswere not significantly correlated (Y = 0.12X – 0.78, r = 0.44, p = 0.20), but high BPlowering effects (score > 5) were observed only in the cases showing a high percentreduction rate (> 80%).

Mentions: PRA, PAC before treatment and prorenin after treatment and their correlation with thescore for the BP lowering effect. These values were not significantly correlated. Thecorrelation coefficients of the score and PRA, PAC and prorenin were 0.06, 0.21 and0.08, respectively.


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)

Reduction rate of (PRA × PAC) and the score for the BP lowering effect. These valueswere not significantly correlated (Y = 0.12X – 0.78, r = 0.44, p = 0.20), but high BPlowering effects (score > 5) were observed only in the cases showing a high percentreduction rate (> 80%).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig_004: Reduction rate of (PRA × PAC) and the score for the BP lowering effect. These valueswere not significantly correlated (Y = 0.12X – 0.78, r = 0.44, p = 0.20), but high BPlowering effects (score > 5) were observed only in the cases showing a high percentreduction rate (> 80%).
Mentions: PRA, PAC before treatment and prorenin after treatment and their correlation with thescore for the BP lowering effect. These values were not significantly correlated. Thecorrelation coefficients of the score and PRA, PAC and prorenin were 0.06, 0.21 and0.08, respectively.

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