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https://www.readbyqxmd.com/read/29786183/-hyperkalemia-as-a-limiting-factor-in-the-use-of-drugs-that-block-the-renin-angiotensin-aldosterone-system-raas
#1
Antonio Santoro, Marcora Mandreoli
Angiotensin-converting enzyme (ACE-I) inhibitors and ARBs have shown real efficacy in reducing blood pressure, proteinuria, in slowing the progression of chronic kidney disease (MRC) and in clinical improvement. in patients with heart failure, diabetes mellitus and ischemic heart disease. However, their use is limited by some side effects such as the increase in serum potassium (K), which can be particularly severe in patients with renal insufficiency. In the 23,000 patients followed by the PIRP project of the Emilia-Romagna Region, hyperkalaemia at the first visit (K> 5...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29778133/study-of-acute-kidney-injury-on-309-hypertensive-inpatients-with-acei-arb-diuretic-treatment
#2
Qiaochao Chen, Shaofang Zhu, Jianjun Liao, Wen He
BACKGROUND: The present study investigated risk factors for acute kidney injury (AKI) in patients found to be hypertensive during hospitalization who were prescribed angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists (ARB) + diuretic combinations, in order to determine which type of diuretic or combination of diuretics used in ACE/ARB-treated patients leads to a higher risk of acute kidney injury. METHOD: Data on basic information, medical history, diagnostic information and medications prescribed were obtained from the patients' medical records...
June 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29767459/long-term-effects-of-patiromer-for-hyperkalaemia-treatment-in-patients-with-mild-heart-failure-and-diabetic-nephropathy-on-angiotensin-converting-enzymes-angiotensin-receptor-blockers-results-from-amethyst-dn
#3
Bertram Pitt, George L Bakris, Matthew R Weir, Mason W Freeman, Mitja Lainscak, Martha R Mayo, Dahlia Garza, Rezi Zawadzki, Lance Berman, David A Bushinsky
AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5...
May 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29726982/a-real-world-cohort-study-on-the-quality-of-potassium-and-creatinine-monitoring-during-initiation-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure
#4
Erik Nilsson, Pietro De Deco, Marco Trevisan, Rino Bellocco, Bengt Lindholm, Lars H Lund, Josef Coresh, Juan J Carrero
AIMS: Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our healthcare. METHODS AND RESULTS: Observational study in 2007-2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods...
May 2, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29699885/impact-of-a-primary-care-ckd-registry-in-a-us-public-safety-net-health-care-delivery-system-a-pragmatic-randomized-trial
#5
Delphine S Tuot, Charles E McCulloch, Alexandra Velasquez, Dean Schillinger, Chi-Yuan Hsu, Margaret Handley, Neil R Powe
BACKGROUND: Many individuals with chronic kidney disease (CKD) do not receive guideline-concordant care. We examined the impact of a team-based primary care CKD registry on clinical measures and processes of care among patients with CKD cared for in a public safety-net health care delivery system. STUDY DESIGN: Pragmatic trial of a CKD registry versus a usual-care registry for 1 year. SETTING & PARTICIPANTS: Primary care providers (PCPs) and their patients with CKD in a safety-net primary care setting in San Francisco...
April 23, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29691148/angiotensin-receptor-blocker-vs-ace-inhibitor-effects-on-hdl-functionality-in-patients-on-maintenance-hemodialysis
#6
R Kaseda, Y Tsuchida, J L Gamboa, J Zhong, L Zhang, H Yang, A Dikalova, A Bian, S Davies, A F Fogo, M F Linton, N J Brown, T A Ikizler, V Kon
BACKGROUND AND AIMS: Angiotensin receptor blockers (ARB) and angiotensin converting enzyme inhibitors (ACEI) reduce cardiovascular events in the general population. Maintenance hemodialysis (MHD) patients are at high cardiovascular risk but few studies have directly addressed the comparative efficacy of these drugs. MHD disrupts the normally atheroprotective actions of high density lipoprotein (HDL), therefore, we compared ACEI or ARB treatment on HDL functions in MHD. METHODS AND RESULTS: HDL was isolated at the starting point (pre) and 3-6 months later (post) in 30 MHD randomly assigned to placebo, ramipril or valsartan...
March 8, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29668213/physician-and-patient-tools-to-improve-chronic-kidney-disease-care
#7
Thomas D Sequist, Alison M Holliday, E John Orav, David W Bates, Bradley M Denker
OBJECTIVES: To determine if electronic health record (EHR) tools and patient engagement can improve the quality of chronic kidney disease (CKD) care. STUDY DESIGN: Randomized controlled trial. METHODS: We enrolled 153 primary care physicians caring for 3947 high-risk and 3744 low-risk patients with stage III CKD across 13 ambulatory health centers in eastern Massachusetts. Intervention physicians received a set of electronic alerts during office visits recommending risk-appropriate CKD care...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29433578/resistant-hypertension-on-treatment-reshypot-sequential-nephron-blockade-compared-to-dual-blockade-of-the-renin-angiotensin-aldosterone-system-plus-bisoprolol-in-the-treatment-of-resistant-arterial-hypertension-study-protocol-for-a-randomized-controlled-trial
#8
Elizabeth do Espirito Santo Cestário, Letícia Aparecida Barufi Fernandes, Luiz Tadeu Giollo-Júnior, Jéssica Rodrigues Roma Uyemura, Camila Suemi Sato Matarucco, Manoel Idelfonso Paz Landim, Luciana Neves Cosenso-Martin, Lúcia Helena Bonalume Tácito, Heitor Moreno, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo
BACKGROUND: Resistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney...
February 12, 2018: Trials
https://www.readbyqxmd.com/read/29381513/a-systematic-review-of-outcomes-associated-with-withholding-or-continuing-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-before-noncardiac-surgery
#9
Caryl Hollmann, Nicole L Fernandes, Bruce M Biccard
BACKGROUND: The global rate of major noncardiac surgical procedures is increasing annually, and of those patients presenting for surgery, increasing numbers are taking either an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB). The current recommendations of whether to continue or withhold ACE-I and ARB in the perioperative period are conflicting. Previous meta-analyses have linked preoperative ACE-I/ARB therapy to the increased incidence of postinduction hypotension; however, they have failed to correlate this with adverse patient outcomes...
January 29, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29374813/dynamic-tissue-perfusion-assessment-reflects-associations-between-antihypertensive-treatment-and-renal-cortical-perfusion-in-patients-with-chronic-kidney-disease-and-hypertension
#10
Arkadiusz Lubas, Grzegorz Kade, Marek Saracyn, Stanisław Niemczyk, Przemysław Dyrla
PURPOSE: Renal cortical perfusion measured in noninvasive, dynamic ultrasonic method is connected with the hemodynamic cardiac properties and renal function. Antihypertensive drugs affect the functioning of the heart and kidneys. The aim of the study was to evaluate the effect of a chronic use of antihypertensive drugs on ultrasound parameters of renal cortical perfusion. METHODS: The study included 56 consecutive patients (49 M + 7 F, age 54.0 ± 13.3) with stable chronic kidney disease and hypertension...
March 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29374807/the-sacubitril-valsartan-a-first-in-class-angiotensin-receptor-neprilysin-inhibitor-arni-potential-uses-in-hypertension-heart-failure-and-beyond
#11
REVIEW
Kazuomi Kario
PURPOSE OF REVIEW: Sacubitril/valsartan (LCZ696) is a first-in-class, novel-acting, angiotensin receptor neprilysin inhibitor (ARNI) that provides inhibition of neprilysin and the angiotensin (AT1 ) receptor. A recent clinical trial PRARDIGM-HF demonstrated that this drug is superior to angiotensin-converting enzyme (ACE) inhibitors for improving the prognosis in the patients with heart failure, and this has resulted in the drug being included in clinical practice guidelines for the management of heart failure with reduced ejection fraction (EF)...
January 27, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29339688/choice-of-treatment-based-on-turkish-hypertension-consensus-report-do-we-follow-the-recommendations
#12
Gülden Yürüyen, İlkim Deniz Toprak, Zeki Toprak, Murat Akarsu, Pınar Demir, Yücel Arman, Eylem Özgün Çil, Mustafa Özcan, Sedat Irmak, Özgür Altun, Şengül Aydın Yoldemir, Hasan Eruzun, Tufan Tükek
OBJECTIVE: The aim of this study was to determine how often the recommendations of the Turkish Hypertension Consensus Report are followed, and to draw attention to the report. METHODS: The demographic information of 1000 patients diagnosed with hypertension and the details of the antihypertensive medications prescribed at the outpatient service of a tertiary care hospital were recorded, and the data were compared with the recommendations of the report. RESULTS: The mean age of the patients was 62±11 years...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29216260/angiotensin-receptor-blockers-are-associated-with-lower-mortality-than-ace-inhibitors-in-predialytic-stage-5-chronic-kidney-disease-a-nationwide-study-of-therapy-with-renin-angiotensin-system-blockade
#13
Chih-Ching Lin, Yu-Te Wu, Wu-Chang Yang, Min-Juei Tsai, Jia-Sin Liu, Chi-Yu Yang, Szu-Yuan Li, Shuo-Ming Ou, Der-Cherng Tarng, Chih-Cheng Hsu
Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit <28% under the treatment with erythropoiesis stimulating agents and RAS blockade...
2017: PloS One
https://www.readbyqxmd.com/read/29179525/aliskiren-therapy-in-hypertension-and-cardiovascular-disease-a-systematic-review-and-a-meta-analysis
#14
REVIEW
Shufang Fu, Xin Wen, Fei Han, Yin Long, Gaosi Xu
The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29119585/effects-of-dopamine-receptor-antagonist-antipsychotic-therapy-on-blood-pressure
#15
REVIEW
N H Gonsai, V H Amin, C G Mendpara, R Speth, G M Hale
WHAT IS KNOWN AND OBJECTIVE: Hypertension, a major risk factor for adverse cardiovascular events, such as stroke and myocardial infarction, affects 80 million American adults. The aetiology of hypertension is multifaceted and difficult to identify. Dopamine receptors, especially those in the kidneys, play a role in blood pressure regulation, and alterations in their function can cause hypertension. The objective of this review was to investigate the association between the use of dopamine antagonists with hypertension focusing especially on second-generation antipsychotics, like clozapine that is D4 receptor antagonist...
February 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29105751/real-life-use-of-neurohormonal-antagonists-and-loop-diuretics-in-chronic-heart-failure-analysis-of-serial-biomarker-measurements-and-clinical-outcome
#16
Milos Brankovic, K Martijn Akkerhuis, Nick van Boven, Olivier Manintveld, Tjeerd Germans, Jasper Brugts, Kadir Caliskan, Victor Umans, Alina Constantinescu, Isabella Kardys
We determined the temporal effects of neurohormonal antagonists and loop diuretics on serially assessed (3-monthly) cardiorenal biomarkers, functional status, and clinical outcomes in 250 patients with chronic heart failure (CHF) with reduced ejection fraction. In blood, we measured NT-proBNP, troponin T, C-reactive protein, creatinine, cystatin C; in urine, N-acetyl-beta-d-glucosaminidase and kidney-injury-molecule-1. Angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) were inversely associated with cardiac impairment, inflammation, and renal tubular damage, but not with glomerular dysfunction...
November 6, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28873219/treatment-effectiveness-in-heart-failure-with-comorbidity-lung-disease-and-kidney-disease
#17
Jerry H Gurwitz, David J Magid, David H Smith, Grace H Tabada, Sue Hee Sung, Larry A Allen, David D McManus, Robert J Goldberg, Mayra Tisminetzky, Alan S Go
OBJECTIVES: To assess the clinical effectiveness of beta-blocker therapy in individuals with heart failure (HF) and chronic lung disease and of angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) in individuals with HF and chronic kidney disease. DESIGN: Retrospective cohort study. SETTING: Community. PARTICIPANTS: Individuals with HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF)...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28753930/pregnancy-proteinuria-plant-based-supplemented-diets-and-focal-segmental-glomerulosclerosis-a-report-on-three-cases-and-critical-appraisal-of-the-literature
#18
Rossella Attini, Filomena Leone, Benedetta Montersino, Federica Fassio, Fosca Minelli, Loredana Colla, Maura Rossetti, Cristiana Rollino, Maria Grazia Alemanno, Antonella Barreca, Tullia Todros, Giorgina Barbara Piccoli
Chronic kidney disease (CKD) is increasingly recognized in pregnant patients. Three characteristics are associated with a risk of preterm delivery or small for gestational age babies; kidney function reduction, hypertension, and proteinuria. In pregnancy, the anti-proteinuric agents (ACE-angiotensin converting enzyme-inhibitors or ARBS -angiotensin receptor blockers) have to be discontinued for their potential teratogenicity, and there is no validated approach to control proteinuria. Furthermore, proteinuria usually increases as an effect of therapeutic changes and pregnancy-induced hyperfiltration...
July 19, 2017: Nutrients
https://www.readbyqxmd.com/read/28751628/aliskiren-therapy-in-hypertension-and-cardiovascular-disease-a-systematic-review-and-a-meta-analysis
#19
REVIEW
Shufang Fu, Xin Wen, Fei Han, Yin Long, Gaosi Xu
The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4...
July 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28724651/hyperkalemia-after-initiating-renin-angiotensin-system-blockade-the-stockholm-creatinine-measurements-scream-project
#20
Ghassan Bandak, Yingying Sang, Alessandro Gasparini, Alex R Chang, Shoshana H Ballew, Marie Evans, Johan Arnlov, Lars H Lund, Lesley A Inker, Josef Coresh, Juan-Jesus Carrero, Morgan E Grams
BACKGROUND: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score. METHODS AND RESULTS: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter...
July 19, 2017: Journal of the American Heart Association
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