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HIPERTANSIF DİYALİZ HASTALARINDA KAPTOPRİL TESTİ

CAPTOPRIL TEST IN HYPERTENSIVE DIALYSIS PATIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In this study the predictivity of captopril test was investigated in 17 HD and 12 CAPD patients, all oj whom were hypertensive. The patients had ultrafiltration until dizziness, muscle cramps appeared. Only those patients remained hypertensive after ultrafiltration were given enalapril. Captopril test predictability were 88% in hypervolemic subgroup, and 78% in normovolemic patients. Pre/post-UF cardiothorasic index; left atrium and other echocardiographic parameters; captopril test positivity were compared. HD group (8.9+3.7%; 5.5+2.9%) and normovolemic/hypervolemic HD subgroups (6.6±2.3;3.3±2.6)/(9.6±3.4; 6.7+2.7) needed more ultrafiltration compared to CAPD pati¬ents (p<0.05). HD patients had higher cardiothorasic index than those of CAPD both before (0.54+0.05; 0.47+0.06, p<0.05) and after (0.45+0.04, 0.41+0.05; p<0.05) ultrafiltration. Regarding left atrium, the difference (27.6+4.6; 19.3+3.3, p<0.001 before UF; 21.1+2.4; 15.5+2, p<0.001 after UF) was also main¬tained. As a result, in all hypertensive patients regardless of the volume status, ultrafiltration must be the first treatment step, if proves ineffective, an ACE inhibitor must be given.
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Abstract (Original Language): 
Hipertansiyon, diyaliz hastalanndaki önemli sorunlardan biridir. Bu çalışmada, onyedi HD, 12 ADPD hastası, tele/ekokardiyografık olarak normo-hipervolemik iki gruba ayrılmıştır. Kaptopril testi (-) ve (+) olgularda önce ultrafiltrasyon yapılarak normotansiyon sağlanmaya çalışılmıştır. Başdönme-si, kas krampları gibi semptomlar ortaya çıkana dek ultrafiltrasyona devam edilmiş, hipertansif kalanlara ise kaptopril testi yapıldıktan sonra enalapril veril¬miştir. Testin belirleyiciliği hipervolemik grupta %88, normovolemik grupta ise %78'dir. Ultrafiltrasyon ön¬ce ve sonrasındaki kan basıncı, kardiyotorasik indeks, sol atrium, sistol ve diastol sonu sol ventrikül çapları¬nın vücut yüzeyine oranı ve kaptopril testi olumluluk yüzdeleri karşılaştınlmıştır. Genel olarak bütün hastalarda (8.9±3.7; 5.5±2.9) ve normo/hipervolemik gruplarda (6.6+2.3; 3.3+2.6) / (9.6±3.4; 6.7+2.7) ultrafiltrasyon yüzdesi, HD'de ADPD'ye göre fazla ol¬muştur (p<0.05). Kardiyotorasik indeks, gerek ultrafiltrasyon öncesi, (0.54+0.05; 0.47±0.06, p<0.05) gerekse sonrası (0.45+0.04, 0.41+0.05; p<0.05) HD grubunda ADPD grubuna göre büyük bulunmuştur. Sol atriyum çapı, ultrafiltrasyon öncesi (27.6+4.6, 19.3+3.3p<0.001) ve sonrası (21.1+2.4; 15.5±2, p<0.001) HD'e göre ADPD grubunda daha küçüktür. Sonuçta; hipertansif olgu tele ve/veya ekokardiy o grafik olarak ister normovolemik isterse hipervolemik olsun, önce UF denenmeli, başarısızlık halinde anjiotensin dönüştürücü enzim inhibitörü ve¬rilmelidir.
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  • Turkish

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