Deterioration of renal function in hypertensive patients with scleroderma despite blood pressure normalization with captopril

1984 ◽  
Vol 62 (15) ◽  
pp. 728-730 ◽  
Author(s):  
B. Waeber ◽  
M. -D. Schaller ◽  
J. -P. Wauters ◽  
H. R. Brunner
2010 ◽  
Vol 16 (3) ◽  
pp. 256-260 ◽  
Author(s):  
M. E. Statsenko ◽  
M. V. Derevjanchenko

Objective. To study the blood pressure variability, morphofunctional parameters of the heart, kidney and metabolic status in hypertensive patients with secondary chronic pyelonephritis. Design and methods. The study included 110 patients: 55 patients with arterial hypertension and secondary chronic pyelonephritis, who underwent surgery for upper urinary tract, and 55 patients with essential arterial hypertension. All patients underwent 24-hour blood pressure monitoring, echocardiography; relative urine density in the morning urine portion, microalbuminuria, blood creatinine were assessed, glomerular fi ltration rate was calculated using MDRD formula. Results. Patients with arterial hypertension and chronic pyelonephritis have signifi cant changes of the blood pressure profi le, and hypertrophy and diastolic left ventricle dysfunction are more frequently observed in this group. A close relation between renal function and the state of the cardiovascular system is established. We also found higher numbers of total cholesterol, the most atherogenic fractions of cholesterol and triglycerides in this group compared to patients with essential hypertension.


Author(s):  
Olugbenga M. Ajulo ◽  
Oluwatoyin H. Ajulo ◽  
Blessing W. Anietimfon ◽  
Idongesit O. Umoh

Aim: Study aimed at evaluating blood pressure (BP) lowering effect of antihypertensive medications and their effect on renal function. Study Design: This was a progressive observational study, evaluating the lowering effect of selected antihypertensive agents on BP and renal functions of hypertensive patients. Study Location: The study involved moderately hypertensive patients who attended Cardiology clinic and were already receiving antihypertensive drug regimen at the University of Uyo Teaching Hospital, Uyo, Akwa-Ibom state, Nigeria. University of Uyo Teaching Hospital is a tertiary healthcare facility that was established in 1999. Methods: Seventy hypertensive patients who received antihypertensive medications for at least 6 months were recruited for the study. The recruited participants were advised on adherence and were given adherence chart to record time of medication used. A 3 ml blood was collected and Omron digital BP meter was used to take three separate BP readings and the average was recorded. The blood samples were analysed in the laboratory for serum creatinine (Scr) by using Randox’s Scr and blood urea nitrogen (BUN) kits. The Scr was used to calculate the creatinine clearance (CrCl) by using Corkcroft-Gault equation. Participants were followed-up for three months consecutively. Statistical analysis was considered significant at p=.05. SPSS version 20 was used for the analysis. Results: Systolic blood pressure (SBP) reduced from 130±2.64 mmHg in phase 1 to 120±1.13 mmHg in phase 3 while CrCl increased from 82.01±4.49 ml/min to 91.62±4.35 ml/min respectively. Both SBP and BUN were higher in females (131±3.30 mmHg and 2.67±0.19 µmol/l)                         while CrCl was higher in males (102.06±8.91 ml/min). Amlodipine (AM) reduced SBP by                           9 mmHg, Lisinopril+Hydrochlorothiazide (LH) reduced SBP by 7 mmHg and Lisinopril+Amlodipine+Hydrochlorothiazide (LAH) reduced SBP by 22 mmHg. CrCl decreased among participants on AM, LH and LAH by 0.89 ml/min, 0.01 ml/min and 8 ml/min respectively. Conclusion: Antihypertensive medications reduced SBP especially in three-drug combinations but worsened renal function.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Salma Naouaoui ◽  
Meriem Chettati ◽  
Wafaa Fadili ◽  
Inass Laouad

Abstract Background and Aims High blood pressure is a leading cause of end stage renal disease (ESRD). However; early detection of chronic kidney disease (CKD) delays progression of kidney failure and reduces the risk of cardiovascular complications. Therefore, the aim of our study was to assess the attitudes and practices of interns and residents regarding screening for chronic kidney disease in patients with high blood pressure at a Moroccan University hospital. Methods A cross-sectional survey was conducted among 100 medical interns and residents at Mohammed VI university hospital of Marrakesh. Results Overall, 82% of the trainees who responded (response rate 89%) stated that they were sensitized to screening for chronic kidney disease in patients with high blood pressure, mainly during their medical studies. However, trainees who systematically monitor renal function in their hypertensive patients did not exceed 13%. While 34% of respondents preferred to refer them to a cardiologist or a nephrologist, and 35% looked for renal impairment only in special situations, dominated by the presence of diabetes or severe hypertension. The main tests used by the participants for monitoring kidney function were represented by blood renal function (100%) and 24h urine protein (61%). Microalbuminuria was mentioned by only 23% of the trainees. The major limits reported by the surveyed physicians were the lack of experience and the non- compliance of patients. Conclusion Our findings revealed inappropriate practices among our training doctors concerning the screening of CKD in hypertensive patients. Therefore, more educational workshops and courses are recommended, especially in low-income countries where access to dialysis is not always affordable.


Author(s):  
Ratna Delima Hutapea ◽  
Yuyun Widaningsih ◽  
Fitriani Mangarengi ◽  
Darwati Muhadi

Hypertension may lead to complications of kidneys and blood vessels. Measurement of urea, creatinine, and platelet indices can be markers of renal function and endothelial dysfunction in hypertensive patients. This study aimed to analyze the profile and correlation between renal function parameters such as urea and creatinine and platelet indices (MPV, PDW, and PCT) with blood pressure in hypertensive patients. One hundred and thirty-third hypertensive patients treated at Wahidin Sudirohusodo Hospital from April to July 2019 were involved in this cross-sectional study. Researchers collected demographic data, blood pressure degrees (based on ESC 2018), systolic and diastolic blood pressure, and urea, creatinine, and platelet index value (MPV, PDW, and PCT) data from the medical record. Descriptive analysis, Spearman test, Fisher exact test, and Kruskal-Wallis test were used confidence interval of 95%. A total of 133 participants were involved in this research. There were significant difference between the mean age (p=0.023), MPV (p=0.032), and PCT (p=0.019) to the degree of hypertension, while gender (p=0.185), urea (p=0.106), creatinine (p=0.498), platelet (p=0.094) and PDW (0.826) showed no significant difference. The bivariate correlation test showed that urea (rs= -0.232 p=0.007) and creatinine (rs= -0.180 p=0.038) had a positive correlation with systolic blood pressure. Platelets index, MPV (rs=0.285 p=0.001), and PDW (rs=0.179) were positively correlated to systolic blood pressure. Also, urea levels and creatinine were positively correlated with MPV value. There was an increase in MPV along with the increase of urea, creatinine. An increase in MPV could be a predictor of endothelial damage and the risk of atherothrombosis.


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