You are here

Home » Content

PRIMER HIPERTANSIYONDA TRANDOLAPRIL VE LOSARTAN TEDAVISININ GLOMERÜLO-TUBÜLER FONKSIYONLARA ETKISI

THE EFFECTS OF TRANDOLAPRİL AND LOSARTAN ON GLOMERULO-TUBULER FUNCTION IN PRIMARY HYPERTENSION

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
İn primary hypertension (HT), organs are damaged by vascular disturbance. The kidney is a major end organ in HT. In antihypertensive theraphy; beside the aim of lowering the blood pressure, use of preparations with organ protective properties is also important. In our study, markers of glomerulo-tubuler function were investigated in 63 HT patients with mean blood pressure (SBP) 158.9± 11.4 mmHg, diyastolic blood pressure (DBP) 99.7 ±6.9 mmHg and compared to 41 healthy individuals. In HT group, the effects of six months trandolapril and losartan theraphy on renal functions were evaluated. In patients group, uric acid (ÜA), proteinuria, urinary albumin excretion (UAE), urinary N-acetyl fi-u glucozaminidase (NAG) and Beta-2-microglobulin $2m) excretion were significantly higher than the control group's. There were a positive linear correlation between UAE and body mass index (BMI), proteinuria, GFR; urinary NAG excretion and SBP, DBP, fi2m excretion and SBP. With a two week salt limited diet, levels of SBP, DBP and Na' were significantly decreased Trandolapril theraphy lead to a significant decrease in proteinuria, UAE, urinary NAG excreation. UA, proteinuria, UAE, urinary NAG and fi2m excretions were seen to be significantly decreased with losartan treatment. Our results show, in patient groups significant glomerulo-tubuler dysfunction were found at early stage. Antihypertensive and renoprotective effects of trandolapril and losartan were found similar.
Bookmark/Search this post with
Abstract (Original Language): 
Primer Hipertansiyon (HT) sonucu organlar vasküler hasarla bozulur ve böbrek önemli hedef organdır. Tedavide, kan basıncı (KB) düşürülmesi yanında, organ koruyucu ilaçların kullanılması da önemlidir. Çalışmamızda, ortalama sistolik kan basıncı (SKB) 158.9 ±11.4 mmHg, diyastolik kan basıncı (DKB) 99.7 ±6.9 mmHg olan 63 HT'lu ile 41 sağlıklıda glomerülo-tubüler fonksiyon göstergeleri araştırılarak, hastalarda altı aylık trandolapril ve losartan tedavisinin renal fonksiyonlara etkisi incelendi. HT'lularda kontrole göre ürik asid (ÜA), proteinüri, üriner albumin atılımı (ÜAE), idrarla N-asetil fi-u glukozaminidaz (NAG) ve Beta-2-mikroglobülin 02m) atılımında anlamlı artışla belirgin glomerülo-tubüler etkilenme saptandı. ÜAE ile DKB, vücut kitle indeksi (VKİ), proteinüri, GFR; üriner NAG atılımı ile SKB, DKB; fi2m atılımı ile SKB pozitif doğrusal ilişkili bulundu. Hastalarda iki hafta tuz kısıtlı diyetle SKB, DKB, Na anlamlı düştü. SKB ve DKB deki anlamlı düşmenin yanısıra trandolapril tedavisi ile proteinüri, ÜAE, üriner NAG atılımı, losartan tedavisi ile ÜA, proteinüri, ÜAE, üriner NAG ve P2m atılımı anlamlı azaldı. Bulgularımız, hastalarımızda erken evrede belirgin glomerülo-tubüler etkilenme oluştuğunu, trandolapril ve losartanın antihipertansifve renoprotektif etkilerinin benzer olduğunu göstermiştir.
FULL TEXT (PDF): 
PDF icon pdf_tndt_387.pdf
  • 2
109-115
  • Turkish

REFERENCES

References: 

1. Berk BC, Alexander RW: Biology of the vascular wall in hypertension. In: Brenner BM, (ed). The Kidney, 5th edition. Philedelphia, WB Saunders Company 1998: 2049-2070
2. Turner ST, Boerwnkle E: Genetics of hypertension, target-
organ complications, and response to therapy. Circulation 2000;102:IV-40-IV-45
3. Luke RG. Hypertensive nephrosclerosis: Pathogenesis and prevalance. Nephrol Dial Transplant 1999; 14: 2271-2278
4. Whelton PK, He J, Perneger TV, Kag MJ. Kidney damage in benign essential hypertension. Curr Opin Nephrol Hypertensl997;6: 177-183
114
5.
Tür
k Nefroloji Derneği Registry 2000: Türk Nefroloji Derneği yayınları; İstanbul 2001; 13-28
6. Bianchi S, Bigazzi R, Campese VM: Microalbuminuria in essential hypertension: significance, pathophsiology, and therapeutic implications. Am J Kidney Dis 1999; 34: 973¬975
7. Schmieder RE, Rockstroh JK, Munch HG, Rüddel H,
Schlebusch: Elevated serum activity of N-Acetyl-P-Glucosaminidase in essential hypertension: diagnostik value and reversal to normal values after antihypertensive therapy. A J KD 1991;18:638-648
8. Scarpelli PT, Chegai E, castigli E, et al.: Renal handling af albumin and P2-microgubulin in hypertension. Nephron 1985;40:122-123
9. Harrap SB: Genetics. In:Oparil S, Weber MA(Eds.). Hypertension. Philadelphia: W.B. Saunders Company, 2000: 29-40
10. Aviv A Salt and hypertension. Arch Intern Med 2001;161:507-510
11. He J, Bazzano LA: Effects of lifestyle modification on treatment and prevention of hypertension. Curr Opin Nephrol Hypertens 2000;9:267-271
12. Subcommittee G: 1999 World Healt Organization-International society of hypertension guidelines for the management of hypertension. Journal of Hypertension 1999;17:151-183
13. Kaplan NM: Evidence in favor of moderate dietary sodium reduction. AJH 2000;13:8-13
14. Plavin PF, Goyene TT, Corool P, Menard J: Clinical investigation of the renin-angiotensin-aldosteron system. In: Davison AM, Cameron SS, Griinfeld JP,Kerr DNS, Ritz E, Winerals C (Eds.) Oxford Textbook of Clinical Nephrology .2nd edition. Oxford: Oxford University Press,1998:1423-1432
15. Hall JE, Brands MW, Henegar JR: Angiotensin II and long-term arterial pressure regulation: the overriding dominance of the kidney. J Am Society Nephrol 1999; 10: S258-S266
16. Jafar TH, Schmid CH, Landa M, Giatras I, Toto R, Remuzzi G, et al. Angotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. Ann Intern Med 2001,135:73-87
17. Ruiz-Ortega M, Lorenzo O, Ruperez M, Egido J. ACE inhibitors and ATI receptor antagonists-beyond the haemodynamic effects. Nephrol Dial Transplant 2000; 15: 561-565
18. Rozzini R, Sabatini T, Frisoni GB,Trabucchi M: Angiotensin receptor blockers. Arch Intern Med 2000;160:1905-1911
19. Gaillard CA, Leeuw PW: Clinical experiences with trandolapril. Am Heart J 1993;125:1542-1546
20. Gfford RW: Angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists,, and calcium antagonists. Medical Clinics of North America 1997;81:1319-1333
21. Fernandez A, Russu D, iversen B, Zucchelli P, Aranda P, Guerra L, Casado S. Comparison of iosartan and amlodipin in renally impaired hypertensive patients. Kidney Int 1998; 54 (suppl 68): S120-S124
22. Culleton B: Uric acid and cardiovascular disease: a renal-cardiac reletionship. Curr Op Nephrol Hypertens 2001; 10: 371-375
23. Fang J, Alderman MH: Serum uric acid and cardiovascular mortality. JAMA 2000; 283: 2410-14
24. Parving HH, Mogensen CE, Jensen HA, Evrin PE: Increased urinary albumin-excretion rate in benign essential hypertension. Lancet 1974;1: 1190-1193
25. Bigazzi R, Bianchi S, Campese VM, Baldari G: Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension. Nephron 1992;61: 94-97
26. Bauduceau B, Genes N, Chamontin B, Vaur L, Renault M, Etienne S, et al. Ambulatory blood pressure and urinary albumin excretion in diabetic (non-insulin dependent and insulin- dependent) hypertensive patients. Am J Hypertens 1998; 11:1065-1073
27. van der Ent M, Remme WJ de leeuw PW, Barteles GL: Renal hemodynamic effects in patients with moderate to severe heart failure during chronic treatment with trandolapril. Cardiovasc drugs and ther 1998; 12: 395-403
28. Metcalf P, Baker J, Scott A, Wüd C, Scragg R, Dryson E:
Albuminuria in people at least 40 years old: effect of obesity, hypertension and hyperlipidemia. Clin Chem 1992;38:1802-1808
29. Burnier M, Roch-Ramel F, Brunner HR: Renal effect of angiotensin II receptor blockade in normotensive subjects. Kidney Int 1996;49:1787-1790
30. Schiffrin EL, Park JB, Intengan HD, Touyz RM: Correction of arterial structure and endothelial dysfunction in human essential hypertension by the angiotensin receptor antagonist Iosartan. Circulation 2000; 101:1653¬1659
31. Holdaas H, Hartmann A, Berg KJ, Lund K, Fauchald P: Renal effects of Iosartan and amlodipine in hypertensive patients with non-diabetic nephropathy. Nephrol Dial Transplant 1998;13:3096-102
32. Brenner BM, Cooper M, Zeeuw DD, Keane WF, Mitch
"WE, Parwing HH, et al.: Effects of Iosartan on renal and cardiovascular outcomes in patients with typr II diabetes and nephropathy. N Engl J Med 2001;345:861-869
33. Simon G, Peterson S: Pathophysiolgy of increased urinary N-acetyl-P-glucosaminidase activity in human hypertension: effects of cilazapril therapy. Clin Exp Hypertens A 1988; Al 0:767-777
34. Sherman RL, Drayer DE, Riedenberg MM: N-acetyl-b-glucosaminidase and b2 microglobulin. Their urinary excretion in patients with renal parenchymal disease. Arch Int Med 1983;143:1183-1185
115

Thank you for copying data from http://www.arastirmax.com