HEMODYNAMIC-RESPONSES TO VERAPAMIL MONOTHERAPY IN PATIENTS WITH RENAL-DISEASE

被引：7

作者：

LENZ, T ^{[1
]}

MULLER, FB ^{[1
]}

SOTELO, JE ^{[1
]}

LARAGH, JH ^{[1
]}

AUGUST, P ^{[1
]}

机构：

[1] CORNELL UNIV,MED CTR,NEW YORK HOSP,CTR CARDIOVASC,525 E 68TH ST,NEW YORK,NY 10021

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1991年 / 4卷 / 12期

关键词：

VERAPAMIL; HYPERTENSION; CHRONIC RENAL FAILURE; RENAL FUNCTION;

D O I：

10.1093/ajh/4.12.939

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

We have explored the effect of verapamil on renal hemodynamics and the renin-aldosterone system in ten patients with chronic renal disease and hypertension before and after 3 months of therapy. The mean +/- SEM glomerular filtration rates were 55 +/- 7 mL/min pre- and 55 +/- 8 mL/min posttherapy; the renal plasma flow was 231 +/- 29 mL/min pre and 244 +/- 35 mL/min posttherapy. The filtration fraction (0.24 pre; 0.23 post) and the renal vascular resistance (492 +/- 144 pre; 422 +/- 101 post) also remained stable with verapamil therapy. Blood pressure was lower after treatment (P < .02) in 7 of 10 patients. Urinary albumin excretion was reduced only when blood pressure was lowered. Verapamil had a modest effect on the renin-aldosterone axis. While the mean increase in plasma renin activity from a pretreatment value of 1.8 +/- 0.42 ng/mL/h to 2.1 +/- 0.56 ng/mL/h failed to reach statistical significance, the increases in urinary aldosterone excretion from 8.2 +/- 2.2 mg/24 h to 11.1 +/- 2.3 mg/24 h did (P < .001). Our results demonstrate that verapamil lowered blood pressure without renal hemodynamic compromise in hypertensive patients with chronic renal disease. The antihypertensive response was associated with a rise in urinary aldosterone excretion, with unchanged serum electrolytes. We conclude that verapamil is effective, safe, and well-tolerated in patients with renal impairment and hypertension, and may be suitable for clinical trials evaluating long-term progression of renal disease.

引用

页码：939 / 943

页数：5

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