BENEFICIAL EFFECTS OF CARVEDILOL IN DILATED CARDIOMYOPATHY IN DIALYSIS PATIENTS

With the growing number of dialysis patients with frailty, the concept of renal rehabilitation, including exercise intervention and nutrition programs for patients with chronic kidney disease (CKD), has become popular recently. Renal rehabilitation is a comprehensive multidisciplinary program for CKD patients that is led by doctors, rehabilitation therapists, diet nutritionists, nursing specialists, social workers, pharmacists, and therapists. Many observational studies have observed better outcomes in CKD patients with more physical activity. Furthermore, recent systematic reviews have shown the beneficial effects of exercise intervention on exercise tolerance, physical ability, and quality of life in dialysis patients, though the beneficial effect on overall mortality remains unclear. Nutritional support is also fundamental to renal rehabilitation. There are various causes of skeletal muscle loss in CKD patients. To prevent muscle protein catabolism, in addition to exercise, a sufficient supply of energy, including carbohydrates, protein, iron, and vitamins, is needed. Because of decreased digestive function and energy loss due to dialysis treatment, dialysis patients are recommended to ingest 1.2-fold more protein than the regular population. Motivating patients to join in activities is also an important part of renal rehabilitation. It is essential for us to recognize the importance of renal rehabilitation to maximize patient satisfaction.

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Growth Hormone and Malnutrition in Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686089501500307 ◽

1995 ◽

Vol 15 (3) ◽

pp. 210-216 ◽

Cited By ~ 2

Author(s):

Peter G. Blake

Keyword(s):

Growth Hormone ◽

Nutritional Status ◽

Data Extraction ◽

Recombinant Human Growth Hormone ◽

Human Growth ◽

Normal Function ◽

Dialysis Patients ◽

Beneficial Effects ◽

Study Selection ◽

End Stage

Objective To review the normal function of the growth hormone (GH) insulin-like growth factor (IGF) axis, how it is altered in end-stage renal failure, how this may contribute to malnutrition in dialysis patients, and how therapy with recombinant human growth hormone (rHuGH) and recombinant human IGF-I (rHuIGF-1)might be used to treat malnutrition in these patients. Data Sources Studies in the literature dealing with the GH-IGF endocrine axis and its role in uremic malnutrition. Study Selection Eight studies in which uremic adults were treated with either rHuGH or rHuIGF-I. Data Extraction Data were abstracted from all of these studies. Results The review shows that there are marked abnormalities of the GH-IGF axis in uremic patients and that these lead to a state of GH resistance, which can be overcome by pharmacological doses of rHuGH. A small number of clinical studies in uremic adults suggests that both rHuGH and rHuIGF-I have dramatic beneficial effects on nutritional status in these patients. Conclusions rHuGH and rHuIGF-I have both been shown to have a beneficial effect on nutritional status in shortterm studies on small numbers of patients. Further studies need to be done for longer periods in larger groups of patients. Areas for additional research are suggested.

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Outcome of Congestive Heart Failure, Dilated Cardiomyopathy, Hypertrophic Hyperkinetic Disease, and Ischemic Heart Disease in Dialysis Patients

American Journal of Nephrology ◽

10.1159/000168084 ◽

1990 ◽

Vol 10 (3) ◽

pp. 213-221 ◽

Cited By ~ 46

Author(s):

Patrick s. Parfrey ◽

Sheila M. Griffiths ◽

John D. Harnett ◽

Rhoda Taylor ◽

Anthony King ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Dilated Cardiomyopathy ◽

Ischemic Heart ◽

Dialysis Patients

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Beneficial effects of long-term carvedilol treatment on hemodynamics and neurohormones in patients with idiopathic dilated cardiomyopathy

Journal of Cardiac Failure ◽

10.1016/s1071-9164(98)90413-4 ◽

1998 ◽

Vol 4 (3) ◽

pp. 95

Author(s):

Yoshihiro Himura ◽

Toshihiro Tamura ◽

Hirokazu Kondo ◽

Chisato Izumi ◽

Moriaki Inoko ◽

...

Keyword(s):

Dilated Cardiomyopathy ◽

Idiopathic Dilated Cardiomyopathy ◽

Beneficial Effects

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Evaluation of add on effect of carvedilol on standard protocol of digoxin, frusemide and benazepril in the management of dilated cardiomyopathy in dogs

Indian Journal of Animal Research ◽

10.18805/ijar.b-3377 ◽

2018 ◽

Author(s):

Akhilesh Kumar ◽

Sahadeb Dey ◽

Abhishek Chandra Saxena ◽

Sumit Mahajan

Keyword(s):

Quality Of Life ◽

Cardiac Function ◽

Dilated Cardiomyopathy ◽

Standard Therapy ◽

Ace Inhibitor ◽

Systolic Function ◽

Serum Levels ◽

Post Treatment ◽

Beneficial Effects

This is a prospective, controlled, randomized clinical trial in canine patients with overt Dilated Cardiomyopathy (DCM). We hypothesized that the addition of the third generation beta-blocker carvedilol to the standard treatment of diuretic (furosemide), inotropic support (digoxin) and ACE-inhibitor (benazepril) would have beneficial effects over cardiac function and quality of life (QoL) that would be measurable 90 days post-treatment. 16 dogs diagnosed with overt DCM were recruited. They underwent clinical examination, electrocardiography, echocardiography and neurohormonal profiling (NT-proBNP and NO). Dogs were divided in two groups, receiving standard therapy or standard therapy plus carvedilol and subjected to re-evaluation on 90 days post-treatment. Our results indicated that the addition of carvedilol to the standard therapy improved echocardiographic indices of systolic function (FS and EF), reduced NT-proBNP and NO serum levels and quality of life within the group but did not showed the significant improvement over standard therapy. This suggested that the addition of carvedilol to the standard therapy in canine patients with overt DCM might have beneficial effects in cardiac function and quality of life in the treatment was continued for longer period.

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