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https://www.readbyqxmd.com/read/29212860/reference-values-of-renal-tubular-function-tests-are-dependent-on-age-and-kidney-function
#1
Anneke P Bech, Jack F M Wetzels, Tom Nijenhuis
Electrolyte disorders due to tubular disorders are rare, and knowledge about validated clinical diagnostic tools such as tubular function tests is sparse. Reference values for tubular function tests are based on studies with small sample size in young healthy volunteers. Patients with tubular disorders, however, frequently are older and can have a compromised renal function. We therefore evaluated four tubular function tests in individuals with different ages and renal function. We performed furosemide, thiazide, furosemide-fludrocortisone, and desmopressin tests in healthy individuals aged 18-50 years, healthy individuals aged more than 50 years and individuals with compromised renal function...
December 2017: Physiological Reports
https://www.readbyqxmd.com/read/29188803/activation-of-human-smooth-muscle-bk-channels-by-hydrochlorothiazide-requires-cell-integrity-and-the-presence-of-bk-%C3%AE-1-subunit
#2
Pedro Martín, Melisa Moncada, Guruprasad Kuntamallappanavar, Alex M Dopico, Verónica Milesi
Thiazide-like diuretics are the most commonly used drugs to treat arterial hypertension, with their efficacy being linked to their chronic vasodilatory effect. Previous studies suggest that activation of the large conductance voltage- and Ca2+-dependent K+ (BK) channel (Slo 1, MaxiK channel) is responsible for the thiazide-induced vasodilatory effect. But the direct electrophysiological evidence supporting this claim is lacking. BK channels can be associated with one small accessory β-subunit (β1-β4) that confers specific biophysical and pharmacological characteristics to the current phenotype...
November 30, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29180859/hyponatremia-in-the-elderly-challenges-and-solutions
#3
REVIEW
Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis
Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the "tea and toast" syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29167564/whole-transcriptome-sequencing-analyses-reveal-molecular-markers-of-blood-pressure-response-to-thiazide-diuretics
#4
Ana Caroline C Sá, Amy Webb, Yan Gong, Caitrin W McDonough, Somnath Datta, Taimour Y Langaee, Stephen T Turner, Amber L Beitelshees, Arlene B Chapman, Eric Boerwinkle, John G Gums, Steven E Scherer, Rhonda M Cooper-DeHoff, Wolfgang Sadee, Julie A Johnson
Thiazide diuretics (TD) are commonly prescribed anti-hypertensives worldwide. However, <40% of patients treated with thiazide monotherapy achieve BP control. This study uses whole transcriptome sequencing to identify novel molecular markers associated with BP response to TD. We assessed global RNA expression levels in whole blood samples from 150 participants, representing patients in the upper and lower quartile of BP response to TD from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) (50 whites) and from PEAR-2 (50 whites and 50 blacks)...
November 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29165723/the-impact-of-hyperosmolarity-on-long-term-outcome-in-patients-presenting-with-severe-hyperglycemic-crisis-a-population-based-study
#5
Ivan Kruljac, Miroslav Ćaćić, Petra Ćaćić, Lora Stanka Kirigin Biloš, Davor Kust, Božidar Perić, Maja Filipović-Grčić, Gorana Mirošević, Vedran Ostojić, Mario Štefanović, Milan Vrkljan
Aims We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors. Methods The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33.0 mmol/L, ketonuria <1+, and serum osmolarity >320 mmol/L. Patients with plasma glucose >33.0 mmol/L, ketonuria <1+ and serum osmolarity <320 mmol/L were considered as controls (nHHS)...
November 17, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/29162216/treatment-regimens-by-pediatric-nephrologists-in-children-with-congenital-nephrogenic-diabetes-insipidus-a-mwpnc-study%C3%A2
#6
Cynthia D'Alessandri-Silva, Melinda Carpenter, John D Mahan
BACKGROUND: Congenital nephrogenic diabetes insipidus (NDI) is a rare genetic disorder affecting urinary concentration. Clinicians have varied medication regimens as well as nutritional plan approaches for these children. MATERIALS AND METHODS: An electronic survey was distributed to member pediatric nephrologists of the Midwest Pediatric Nephrology Consortium via email (n = 179). Questions included types of drugs prescribed, factors contributing to drug choice, common drug combinations given, and dietary/failure to thrive interventions used...
November 22, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29153114/cost-effectiveness-analyses-of-antihypertensive-medicines-a-systematic-review
#7
REVIEW
Chanhyun Park, Guijing Wang, Jefferey M Durthaler, Jing Fang
CONTEXT: Hypertension affects one third of the U.S. adult population. Although cost-effectiveness analyses of antihypertensive medicines have been published, a comprehensive systematic review across medicine classes is not available. EVIDENCE ACQUISITION: PubMed, Embase, Cochrane Library, and Health Technology Assessment were searched to identify original cost-effectiveness analyses published from 1990 through August 2016. Results were summarized by medicine class: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), thiazide-type diuretics, β-blockers, and others...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29152588/the-delivery-science-rapid-analysis-program-a-research-and-operational-partnership-at-kaiser-permanente-northern-california
#8
Julie A Schmittdiel, Rick Dlott, Joseph D Young, Michael B Rothmann, Wendy Dyer, Alyce S Adams
Introduction: Health care researchers and delivery system leaders share a common mission to improve health care quality and outcomes. However, differing timelines, incentives, and priorities are often a barrier to research and operational partnerships. In addition, few funding mechanisms exist to generate and solicit analytic questions that are of interest to both research and to operations within health care settings, and provide rapid results that can be used to improve practice and outcomes...
October 2017: Learning Health Systems
https://www.readbyqxmd.com/read/29152298/medullary-nephrocalcinosis-in-idiopathic-hypercalciuria
#9
Abhilash Koratala, Vikrampal Bhatti
Idiopathic hypercalciuria is a metabolic abnormality characterized by excessive calcium excretion in the urine with normal serum calcium levels and is a common risk factor for formation of kidney stones and/or nephrocalcinosis. These patients benefit from a normal-calcium, reduced-animal protein, and low-salt diet, along with a thiazide diuretic.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#10
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29145890/pharmacokinetic-study-of-single-and-multiple-dosing-with-metolazone-tablets-in-healthy-chinese-population
#11
Xueqing Li, Rutao Wang, Yang Liu, Yun Liu, Heng Zheng, Yabo Feng, Na Zhao, Hongbin Geng, Wanzhi Zhang, Aidong Wen
BACKGROUND: Metolazone is a diuretic, saluretic and antihypertensive chemical compound from the quinazoline category that possesses medicinal features similar to those of other thiazide diuretic drugs. However, the pharmacokinetics of metolazone in the Chinese population has rarely been studied. This study aimed to examine the pharmacokinetic characteristics, safety characteristic, and tolerability of metolazone in healthy Chinese subjects after single and multiple doses taken orally as well as the effects that food and gender have on oral metolazone pharmacokinetic parameters...
November 16, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29133355/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#12
REVIEW
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 13, 2017: Hypertension
https://www.readbyqxmd.com/read/29131070/pathophysiology-of-post-transplant-hypertension-in-kidney-transplant-focus-on-calcineurin-inhibitors-induced-oxidative-stress-and-renal-sodium-retention-and-implications-with-rhoa-rho-kinase-pathway
#13
Lorenzo A Calò, Verdiana Ravarotto, Francesca Simioni, Elena Naso, Francesco Marchini, Luciana Bonfante, Lucrezia Furian, Paolo Rigotti
Post-transplant hypertension is a common occurrence during treatment with calcineurin inhibitors (CNIs) in kidney transplant population. The pathogenesis of vasoconstriction induced by CNIs involves vascular tone alterations and kidney sodium transport regulation. Among the factors involved a key role is played by the activation of intrarenal renin-angiotensin system with enhanced release of Angiotensin II (Ang II) and increase of oxidative stress. A common pathway between oxidative stress and hypertension induced by CNIs may be identified in the involvement of the activation of RhoA/Rho kinase pathway, key for the induction of hypertension and cardiovascular-renal remodeling, of the oxidative stress mediated increased nitric oxide (NO) metabolism and increased renal sodium retention via increased activity of thiazide-sensitive sodium chloride cotransporter (NCC) in the distal tubule...
October 16, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29129996/addressing-hypertension-in-the-patient-with-type-2-diabetes-mellitus-pathogenesis-goals-and-therapeutic-approach
#14
Ali A Rizvi
Hypertension is considered a powerful cardiovascular risk factor and is present in up to two-thirds of patients who suffer from diabetes. In the background of an established epidemiological association between lower blood pressure (BP) and improvement in long-term clinical outcomes, several large landmark trials and analyses have attempted to examine the possible benefit of tighter BP control in patients with Type 2 diabetes mellitus. Although aggressive BP targets in patients with diabetes have been advocated for a long time, currently accepted evidence from these studies has led to a general recommendation of systolic BP <140 mmHg and diastolic BP <90 mmHg...
October 2017: European Medical Journal. Diabetes
https://www.readbyqxmd.com/read/29110406/switching-from-low-dose-thiazide-diuretics-to-sodium-glucose-cotransporter-2-inhibitor-improves-various-metabolic-parameters-without-affecting-blood-pressure-in-patients-with-type-2-diabetes-and-hypertension
#15
Tomohiko Kimura, Junpei Sanada, Masashi Shimoda, Hidenori Hirukawa, Yoshiro Fushimi, Momoyo Nishioka, Tomoe Kinoshita, Seizo Okauchi, Atsushi Obata, Kenji Kohara, Fuminori Tatsumi, Shinji Kamei, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
AIMS/INTRODUCTION: Sodium-glucose cotransporter 2 (SGLT2) inhibitors function to increase urinary glucose excretion and improve glycemic control in individuals with type 2 diabetes mellitus. SGLT2 inhibitors, as well as diuretics, increase urinary volume, which leads to the reduction of blood pressure. The aim of the present study was to compare the effects of SGLT2 inhibitor and thiazide diuretic on blood pressure, metabolic parameters and body mass composition. MATERIALS AND METHODS: A total of 31 participants were enrolled in the present study...
November 7, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29106774/do-thiazide-diuretics-reduce-central-systolic-blood-pressure-in-hypertension
#16
EDITORIAL
Lara B T Yugar, Beatriz Moreno, Heitor Moreno, José F Vilela-Martin, Juan C Yugar-Toledo
No abstract text is available yet for this article.
November 6, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29097388/genetic-variants-associated-with-uncontrolled-blood-pressure-on%C3%A2-thiazide-diuretic-%C3%AE-blocker-combination-therapy-in-the-pear-pharmacogenomic-evaluation-of-antihypertensive-responses-%C3%A2-and-invest-international-verapamil-sr-trandolapril-study-trials
#17
Oyunbileg Magvanjav, Yan Gong, Caitrin W McDonough, Arlene B Chapman, Stephen T Turner, John G Gums, Kent R Bailey, Eric Boerwinkle, Amber L Beitelshees, Toshihiro Tanaka, Michiaki Kubo, Carl J Pepine, Rhonda M Cooper-DeHoff, Julie A Johnson
BACKGROUND: The majority of hypertensive individuals require combination antihypertensive therapy to achieve adequate blood pressure (BP) control. This study aimed to identify genetic variants associated with uncontrolled BP on combination therapy with a thiazide diuretic and a β-blocker. METHODS AND RESULTS: A genome-wide association study of uncontrolled BP on combination therapy was conducted among 314 white participants of the PEAR (Pharmacogenomic Evaluation of Antihypertensive Responses) trial...
November 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29069246/hypercalcemia-in-children-three-cases-report-with-unusual-clinical-presentations
#18
Bruna Barros Garbim, Larissa D Ávila, Sumara Zuanazi Pinto Rigatto, Kélcia Rosana da Silva Quadros, Vera Maria Santoro Belangero, Rodrigo Bueno de Oliveira
Hypercalcemia is a rare condition in childhood; the most common causes are primary hyperparathyroidism, malignancy, prolonged immobilisation, thyrotoxicosis, thiazide diuretic, supplements containing calcium, milk-alkali syndrome, vitamin D intoxication, infections and idiopathic. We present three cases of severe hypercalcemia of unusual causes in children. The first patient had high fever, poor general condition, weight loss and myalgia. Extensive preliminary investigation did not define the etiology, but a review of medical history revealed prolonged contact with pet bird and a positive serology for Chlamydia confirmed the diagnosis of psittacosis...
April 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29047359/thiazides-in-the-management-of-hypertension-in-older-adults-a-systematic-review
#19
REVIEW
Christina Sommerauer, Neha Kaushik, Adrine Woodham, Anna Renom-Guiteras, Yolanda V Martinez, David Reeves, Ilkka Kunnamo, Thekraiat Al Qur An, Steffen Hübner, Andreas Sönnichsen
BACKGROUND: Thiazides are commonly prescribed to older people for the management of hypertension. The objective of this study was to identify the evidence on the risks and benefits of their use among adults aged ≥65 years and to develop recommendations to reduce potentially inappropriate use. METHODS: Systematic review (SR) of the literature covering six databases. We applied a staged search approach, where each search was undertaken only if the previous one did not yield high quality results...
October 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29045766/population-pharmacodynamic-analysis-of-uric-acid-lowering-effects-of-febuxostat-based-on-electronic-medical-records-in-two-hospitals
#20
Shota Muraki, Kuniaki Moriki, Saki Shigematsu, Masato Fukae, Makoto Kakara, Daiki Yamashita, Takeshi Hirota, Hiroshi Takane, Miki Shimada, Masaaki Hirakawa, Ichiro Ieiri
The aim of this study was to develop a population pharmacodynamic (PPD) model to describe uric acid (UA)-lowering effects in patients treated with febuxostat based on electronic medical records in 2 independent hospitals (university and city hospitals). Interhospital differences in the PPD model were also evaluated. We conducted the following 2 approaches to build the PPD models. A PPD model was developed separately using individual hospital data, and structural models and covariates between the two hospitals were compared (approach A)...
October 18, 2017: Journal of Clinical Pharmacology
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