- Publikační typ
- abstrakt z konference MeSH
The primary aim of this study was evaluation of the efficacy of telmisartan (angiotensin II receptor blocker- AT(1) blocker) on blood pressure in 10 patients with renal impairment in moderate or advanced stages of renal insufficiency and not dependent on haemodialysis. Its effect on proteinuria, renal function (represented by serum urea, creatinine, glomerular filtration), evaluation of overall therapy compliance in comparison with a previously prescribed angiotensin converting enzyme inhibitors (ACEI) were secondary aims. Considering the presence of left ventricle hypertrophy in all patients as a marker of hypertensive cardiopathy, the effect of telmisartan therapy on non-invasive cardiovascular parameters (ECG, echocardiography, and assessment of heart rate variability-HRV) was also evaluated. The study group involved 10 hypertensive patients (6 women, 4 men) with diabetic and non-diabetic renal impairment, proteinuria above 1 g/24 hours, hypertensive cardiopathy and intolerance of ACEI (cough). Telmisartan was added to their long-term antihypertensive combination therapy in a dose of 40 mg for the first 14 days, after which the dose increased to the maximal of 80 mg. The average initial daytime systolic blood pressure (SBP) was 149 +/- 19.7 mm Hg, average night-time SBP 145 +/- 23.0 mm Hg, average initial daytime diastolic BP (DBP) 90.6 +/- 2.5 mm Hg, night-time DBP 88.9 +/- 13.5 mm Hg. Average initial serum creatinine was 207.2 +/- 48.5 micromol/l, urea 15.1 +/- 4.4 mmol/l, GF 0.5 +/- 0.1 ml/s. Echocardiography revealed left ventricular (LV) hypertrophy with well preserved systolic and moderately impaired diastolic LV function. Also the HRV assessment revealed impaired neurovegetative (e.g. sympathovagal) balance. After 1 year of combination therapy with telmisartan, there was a clearly significant reduction in both SBP and DBP in both day and night-time (SBP daytime 149.6 vs.116.6 mm Hg, night-time 145.8 vs. 129.5 mm Hg; DBP daytime 90.6 vs. 83.5 mm Hg, night-time 88.9 vs. 79.3 mm Hg) and proteinuria (2.37 vs. 1.27 g/24 hour, p < 0.05). There were no significant changes in serum creatinine, urea values, and LV functions. On the other hand, further progression of the sympathovagal balance impairment was noted (continuing reduction of HRV in 9 from 10 patients), which can be described as the priority finding. The total compliance of telmisartan therapy was very good and without adverse clinical side effects. In conclusion - telmisartan reduces blood pressure and proteinuria safely and effectively in patients with various types of nephropathy in moderate or advanced stages of renal insufficiency.
- MeSH
- benzimidazoly terapeutické užití MeSH
- benzoáty terapeutické užití MeSH
- blokátory receptoru 1 pro angiotenzin II terapeutické užití MeSH
- chronické selhání ledvin komplikace patofyziologie MeSH
- diabetické nefropatie komplikace MeSH
- inhibitory ACE terapeutické užití MeSH
- krevní tlak účinky léků MeSH
- lidé MeSH
- renální hypertenze farmakoterapie patofyziologie MeSH
- srdeční frekvence účinky léků MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
Renal osteodystrophy is a common finding in patients with renal insufficiency. The maximum of its intensity is found in hemodialysis patients. Bone densitometry is so far the best method for non-invasive assessment of the extent of the illness. Some densitometric studies in hemodialysis patients have already been published but their results differ in prevalence and intensity of renal osteodystrophy. They also demonstrated a slight relationship between intensity of renal osteodystrophy and duration of the dialysis treatment. Opinions vary on the relationship between bone mineral density and markers of bone turnover. This cross-sectional study found high prevalence of renal osteodystrophy (Z-score below -1 in 57% of patients) as well as high a number of severely damaged patients (T-score below -2.5 in 40% of patients). It also showed some correlation between bone demineralisation and the duration of dialysis. None from evaluated markers of bone turnover correlated with bone mineral density.
- MeSH
- absorpční fotometrie * MeSH
- dialýza ledvin * škodlivé účinky MeSH
- kostní denzita * MeSH
- lidé středního věku MeSH
- lidé MeSH
- minerálová a kostní nemoc při chronickém onemocnění ledvin diagnostické zobrazování farmakoterapie MeSH
- radioisotopová scintigrafie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
19 l. : il. ; 32 cm
Kobntrolvanou randomizovanou studií je problém senzibilizovaných příjemců ledvinových štěpů. Po profylaktickém podání antithymocytárního globulínu je sledované přežívání štěpu a nemocných, komplikace, dlouhodobá prognóza. Cíl: objektivizovat přínos ATG.XXX XXX XXX
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- alergologie a imunologie
- transplantologie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
Basing on three types of questionnaires, the authors summarized the incidence of all malignant diseases in kidney transplant patients in CSFR. The total number of registered tumours was 34. Previously to the transplantation, two patients with malignancies were found, another one was transplanted for a kidney tumour and 31 patients manifested malignant diseases in various time intervals following the transplantation. This number is five times greater than the incidence of tumours in the standard population. At classical immunosuppression, the mean time interval between transplantation and tumour formation is 48 months; at cyclosporine application, it decreases to 19 months. The most frequent sites of tumour formation are the skin and the kidney. The early diagnosis of tumours and the surgical treatment will increase the survival period up to 58 months. The systematic oncologic follow-up and preventive controls of transplant patients represent one of the possibilities of the prolongation of the patient's life with the functional graft.
- MeSH
- imunosupresivní léčba metody MeSH
- incidence MeSH
- lidé MeSH
- nádory ledvin epidemiologie etiologie MeSH
- registrace MeSH
- transplantace ledvin škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Československo MeSH
