Improvement of hypertension and LVH in maintenance hemodialysis patients treated with sustained-release isosorbide mononitrate.

Abstract:

BACKGROUND:Hypertension and left ventricular hypertrophy (LVH) are independent predictors of morbidity and mortality in maintenance hemodialysis (MHD) patients. The level of serum asymmetric dimethylarginine (ADMA) is increased in MHD patients, which is a kind of uremic toxin. It can competitively inhibit nitric oxide production from L-arginine, which can increase vascular resistance, then lead to endothelium dysfunction, hypertension, LVH and decrease of ejection fraction. A sustained-release preparation of isosorbide mononitrate can lead to vasodilatation by releasing nitrogen monoxide. But it remains unclear whether oral isosorbide mononitrate in MHD patients can control blood pressure (BP) and reverse LVH. The aim of the present study was to evaluate the safety and efficacy of oral sustained-release isosorbide mononitrate on hypertension and LVH in MHD patients. METHODS:One hundred and forty-four MHD patients with hypertension were enrolled in this perspective, randomized, controlled, single-center trial. All patients accepted antihypertensive drugs at baseline, including renin-angiotensin system inhibitor, calcium channel blocker, ß-receptor blocker or a-receptor blocker. Seventy-two patients (nitrate group) took isosorbide mononitrate 30 mg daily, titered to a maximal dosage of 120 mg daily for 24 weeks. The dosage was adjusted once a week according to BP. The remaining 72 patients (non-nitrate group) did not take nitrate drugs other than antihypertensive drugs. BP, left ventricular mass index (LVMI), heart rate, interdialytic weight gain (IDWG) and hemoglobin (Hb) were monitored. RESULTS:After 4, 8, 12 and 24 weeks of treatment, BP levels decreased in both nitrate and non-nitrate groups. BP in the nitrate group was significantly lower than in the non-nitrate group. But there was no statistical significance in the levels of response rate and control rate of BP between the 2 groups (response rate of BP: 91.4% vs. 86.1%, X2=1.004, p=0.316; control rate of BP: 60.0% vs. 47.2%, X2=2.230, p=0.127). BP before hemodialysis was maintained between 12 and 24 weeks in the nitrate group despite the decrease in total daily category and quantity of hypotensive drugs. At week 24 of treatment, LVMI in the nitrate group was significantly decreased from 65.3 ± 14.2 g/m2.7 to 51.2 ± 10.0 g/m2.7, and that in the non-nitrate group was also significantly decreased from 63.7 ± 16.7 g/m2.7 to 56.1 ± 13.8 g/m2.7. But LVMI in the nitrate group was significantly lower than that in the non-nitrate group. The prevalence of LVH in the nitrate and non-nitrate groups decreased 17.2% and 9.8%, respectively. There was a significant difference in both groups at 24 weeks (X2=4.480, p=0.034). During 24 weeks of follow-up, the incidence of acute left heart failure in the nitrate group was 1.4% (1/70), which was significantly lower than in the non-nitrate group (11.1%, 8/72; X2=5.605, p=0.033). The incidence of adverse events was 1.4%. CONCLUSIONS:Sustained-release isosorbide mononitrate, which is safe and well tolerated, can effectively control BP, decrease the category and quantity of hypotensive drugs, improve left ventricular hypertrophy and reduce the incidence of acute left heart failure in MHD patients.

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Li H,Wang SX

doi

10.5301/jn.2011.6252

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

236-45

issue

2

eissn

1121-8428

issn

1724-6059

pii

C14AC0D8-209D-49CE-9626-8858AC1922DF

journal_volume

24

pub_type

杂志文章,随机对照试验
  • Diabetic kidney disease: new clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on "The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with

    abstract:AIMS:This joint document of the Italian Diabetes Society and the Italian Society of Nephrology reviews the natural history of diabetic kidney disease (DKD) in the light of the recent epidemiological literature and provides updated recommendations on anti-hyperglycemic treatment with non-insulin agents. DATA SYNTHESIS:...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-019-00650-x

    authors: Pugliese G,Penno G,Natali A,Barutta F,Di Paolo S,Reboldi G,Gesualdo L,De Nicola L,Italian Diabetes Society and the Italian Society of Nephrology.

    更新日期:2020-02-01 00:00:00

  • Adiponectin secreted by tubular renal cells during LPS exposure worsens the cellular inflammatory damage.

    abstract::The pathogenetic role of adiponectin (ADPN) in kidney failure is not yet elucidated, since in vitro and in vivo studies have demonstrated that ADPN exerts both anti-inflammatory and pro-inflammatory effects. Starting from our previous findings demonstrating that HK-2 cells express and secrete ADPN, in this study we in...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-015-0220-2

    authors: Perri A,Vizza D,Lupinacci S,Toteda G,De Amicis F,Leone F,Gigliotti P,Lofaro D,La Russa A,Bonofiglio R

    更新日期:2016-04-01 00:00:00

  • Is it possible to use modification of diet in renal disease (MDRD) equation in a Brazilian population?

    abstract:BACKGROUND:Accurate assessment of kidney function level is the key to the identification and management of chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best measure of overall kidney function in health and disease. There is no consensus about the method to be used routinely to measure and/or es...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Nóbrega AM,Gomes CP,Lemos CC,Bregman R

    更新日期:2006-03-01 00:00:00

  • Hypertension and progression of renal disease.

    abstract::That systemic hypertension is involved in the progression of human renal disease is mostly suggested by the way anti-hypertensive treatment affects the course of the disease. Clinical evidence has been obtained from observational studies as well as from studies of dietary protein restriction. In addition, several tria...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:

    authors: Maschio G,Oldrizzi L,Marcantoni C,Rugiu C

    更新日期:2000-05-01 00:00:00

  • Sodium removal and plasma tonicity balance are not different in hemodialysis and hemodiafiltration using high-flux membranes.

    abstract:BACKGROUND:The clinical benefits of on-line hemodiafiltration (HDF) versus high-flux membranes hemodialysis (hf-HD) are still debated. In fact, although a superiority of one treatment over the other, especially in terms of mortality, did not emerge from the analysis of clinical trials, improved intradialytic vascular s...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-018-00581-z

    authors: La Milia V,Ravasi C,Carfagna F,Alberghini E,Baragetti I,Buzzi L,Ferrario F,Furiani S,Barbone GS,Pontoriero G

    更新日期:2019-06-01 00:00:00

  • Palliative care in nephrology.

    abstract::The goal of palliative care is to achieve good quality of life for patients with chronic life-limiting illnesses, and their families, through assessment and management of physical, psychosocial and spiritual problems and needs. Patients with kidney diseases present a particular target of such care from the time of dia...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Lichodziejewska-Niemierko M,Rutkowski B

    更新日期:2008-03-01 00:00:00

  • Mixed hemodiafiltration reduces erythropoiesis stimulating agents requirement in dialysis patients: a prospective randomized study.

    abstract:BACKGROUND:Improved responsiveness to erythropoiesis stimulating agents (ESAs) in patients on on-line post-dilution hemodiafiltration (Post-HDF) compared with conventional hemodialysis (HD) was reported by some authors but challenged by others. This prospective, cross-over randomized study tested the hypothesis that an...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-020-00709-0

    authors: Pedrini LA,Comelli M,Ruggiero P,Feliciani A,Manfrini V,Cozzi G,Castellano A,Pezzotta M,Gatti G,Arazzi M,Auriemma L,di Benedetto A,Stuard S

    更新日期:2020-10-01 00:00:00

  • Sudden cardiac death in end stage renal disease: unlocking the mystery.

    abstract::Sudden cardiac death (SCD) is a major cause of concern in end stage renal disease (ESRD), contributing to 70% of cardiovascular mortality and 27% of all-cause mortality in dialysis patients. Yet its mechanisms and pathogenesis remain largely obscure. This review discusses the potential reasons for an exaggerated risk ...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-014-0151-3

    authors: Zachariah D,Kalra PR,Roberts PR

    更新日期:2015-04-01 00:00:00

  • Acute colchicine intoxication during clarithromycin administration in patients with chronic renal failure.

    abstract::Colchicine is an effective antiinflammatory medication. It should be used with great caution, however, in patients requiring dialysis. Coadministration of colchicine and macrolides may impair colchicine elimination, resulting in excess drug exposure and toxicity. We report 2 renal failure cases of colchicine intoxicat...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Akdag I,Ersoy A,Kahvecioglu S,Gullulu M,Dilek K

    更新日期:2006-07-01 00:00:00

  • Dialysis requirement, long-term major adverse cardiovascular events (MACE) and all-cause mortality in hospital acquired acute kidney injury (AKI): a propensity-matched cohort study.

    abstract:BACKGROUND:Dialysis-requiring acute kidney injury (D-AKI) is common in hospitalized patients. Many patients survive the immediate post AKI period, thus at risk of suffering long-term sequelae of AKI. Prior studies examining long term outcomes lack non-dialyzed AKI control groups. Without non-dialyzed AKI control group,...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-016-0321-6

    authors: Omotoso BA,Abdel-Rahman EM,Xin W,Ma JZ,Scully KW,Arogundade FA,Balogun RA

    更新日期:2016-12-01 00:00:00

  • Therapeutic implications of shared mechanisms in non-alcoholic fatty liver disease and chronic kidney disease.

    abstract::The most common cause of liver disease worldwide is now non-alcoholic fatty liver disease (NAFLD). NAFLD refers to a spectrum of disease ranging from steatosis to non-alcoholic steatohepatitis, causing cirrhosis, and ultimately hepatocellular carcinoma. However, the impact of NAFLD is not limited to the liver. NAFLD h...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-020-00751-y

    authors: Kanbay M,Bulbul MC,Copur S,Afsar B,Sag AA,Siriopol D,Kuwabara M,Badarau S,Covic A,Ortiz A

    更新日期:2020-05-21 00:00:00

  • Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis.

    abstract:BACKGROUND:Chronic kidney disease (CKD) progression is associated with significant comorbidities and costs. In Italy, limited evidence of healthcare resource consumption and costs is available. We therefore aimed to investigate the direct healthcare costs in charge to the Lombardy Regional Health Service (RHS) for the ...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-016-0291-8

    authors: Roggeri A,Roggeri DP,Zocchetti C,Bersani M,Conte F,ReNe (Renal Lombardy Network).,Additional contributors from ReNe Network.

    更新日期:2017-04-01 00:00:00

  • Cellular and molecular biology of membranous nephropathy.

    abstract::There have been dramatic increases in the understanding of the molecular mechanisms involved in membranous nephropathy (MN) over the past 2 decades. Most of these have come directly from studies carried out in the Heymann nephritis models of MN in rats, which closely simulate the clinical and pathologic features of th...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:

    authors: Couser WG,Nangaku M

    更新日期:2006-11-01 00:00:00

  • Plasma sulfate concentration and hyperhomocysteinemia in hemodialysis patients.

    abstract:BACKGROUND:Severe hyperhomocysteinemia is common in hemodialysis patients, who also present a dramatic increase in plasma concentrations of sulfate, one of the main products of methionine and cysteine catabolism. The aim of this study was to verify the relationship between high plasma sulfate levels and cysteine or hom...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Brunetti M,Terracina L,Timio M,Saronio P,Capodicasa E

    更新日期:2001-01-01 00:00:00

  • Ascariasis as a cause of obstructive jaundice in a renal transplant patient.

    abstract::Jaundice and pancreatitis are serious complications in post renal transplantations; hepatotropic viruses and drugs are commonly implicated. We describe ascaris infestation causing pancreatitis and obstructive jaundice in a renal transplant patient. ...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Sunil P,Tribhuvan G,Anil M

    更新日期:2004-05-01 00:00:00

  • The vascular endothelium in chronic renal failure.

    abstract::Chronic renal failure (CRF) is associated with a 20-fold increased risk of cardiovascular death, two principal mechanisms being: sudden, arrhythmic death associated with left ventricular hypertrophy, and ischaemic heart disease, associated with accelerated atherosclerosis. In recent years, the vascular endothelium has...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:

    authors: Morris ST,Jardine AG

    更新日期:2000-03-01 00:00:00

  • Visfatin is related to lipid dysregulation, endothelial dysfunction and atherosclerosis in patients with chronic kidney disease.

    abstract:BACKGROUND AND AIMS:This study aimed to test the hypothesis that visfatin is associated with atherosclerosis in patients with chronic kidney disease (CKD). METHODS:In the study, we measured serum triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol lev...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.5301/jn.2010.3488

    authors: Mu J,Feng B,Ye Z,Yuan F,Zeng W,Luo Z,Qi W

    更新日期:2011-03-01 00:00:00

  • Fibroblast growth factor 23: are we ready to use it in clinical practice?

    abstract::Patients with chronic kidney disease (CKD) have a greatly enhanced risk of cardiovascular morbidity and mortality. Over the past decade it has come clear that a disturbed calcium-phosphate metabolism, with Fibroblast Growth Factor-23 as a key hormone, is partly accountable for this enhanced risk. Numerous studies have...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-020-00715-2

    authors: Bouma-de Krijger A,Vervloet MG

    更新日期:2020-06-01 00:00:00

  • Relationship of chronic kidney disease to cardiovascular death and myocardial infarction following coronary stenting.

    abstract:BACKGROUND:Chronic kidney disease is a risk factor for death in the year following myocardial infarction or coronary angioplasty. Whether the risk is similar after coronary stenting, whether impaired renal function is associated with an increased risk of cardiovascular death or myocardial infarction (MI) after coronary...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Charytan DM,Kuntz RE,Chhabra A,Cutlip DE

    更新日期:2006-11-01 00:00:00

  • Proximal renal tubular acidosis.

    abstract::The proximal tubule reabsorbs approximately 80% of the filtered load of bicarbonate. Defects in the process of bicarbonate reabsorption result in loss of bicarbonate and proximal renal tubular acidosis. Global proximal tubule dysfunction is known as the Fanconi's syndrome. Both isolated proximal renal tubular acidosis...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:

    authors: Quigley R

    更新日期:2006-03-01 00:00:00

  • Association between malnutrition, integrin expression and impaired granulocyte adhesion in chronically hemodialyzed patients.

    abstract:BACKGROUND:The relationship between malnutrition in hemodialysis (HD) patients with a chronic inflammatory condition and the expression levels of leukocyte integrins and their adhesiveness to fibronectin was investigated. METHODS:Subjective global assessment, albumin and body mass index were used as nutritional marker...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Corradi-Perini C,Riella MC,Cattaneo RI,Weffort-Santos AM

    更新日期:2010-03-01 00:00:00

  • Effect of n-3 polyunsaturated fatty acids on cyclosporine pharmacokinetics in kidney graft recipients: a randomized placebo-controlled study.

    abstract::Highly concentrated marine polyunsaturated fatty acids (n-3 PUFA), affecting the lipids and lipophilic drugs metabolism, can interfere with cyclosporine (CyA) pharmacokinetics. This prospective, randomized and placebo-controlled, double-blind study involved 42 kidney graft recipients. From day +1, 21 pts (E) received ...

    journal_title:Journal of nephrology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Busnach G,Stragliotto E,Minetti E,Perego A,Brando B,Broggi ML,Civati G

    更新日期:1998-03-01 00:00:00

  • Hyperuricosuric calcium urolithiasis.

    abstract::Hyperuricosuric calcium urolithiasis is a condition of mixed calcium oxalate stones characterized by hyperuricosuria either in isolation or in conjunction with other risk factors for calcium oxalate stones such as hypercalciuria, hyperoxaluria, and hypocitraturia. There are three proposed physicochemical models of pat...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-018-0469-3

    authors: Moe OW,Xu LHR

    更新日期:2018-04-01 00:00:00

  • Effects of short daily hemodialysis and extended standard hemodialysis on blood pressure and cardiac hypertrophy: a comparative study.

    abstract:BACKGROUND:Causes of hypertension and cardiac hypertrophy in hemodialysis (HD) patients are multiple, but the role of fluid overload appears to be crucial. Short daily HD (sDHD = 2 hr x 6/week) seems to allow reductions in left ventricular mass (LVM) through the reduction of extracellular water (ECW). Better cardiovasc...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Fagugli RM,Pasini P,Pasticci F,Ciao G,Cicconi B,Buoncristiani U

    更新日期:2006-01-01 00:00:00

  • Blood pressure reduction and RAAS inhibition in diabetic kidney disease: therapeutic potentials and limitations.

    abstract::Diabetic kidney disease (DKD) affects approximately one-third of patients with diabetes and taking into consideration the high cardiovascular risk burden associated to this condition a multifactorial therapeutic approach is traditionally recommended, in which glucose and blood pressure control play a central role. The...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.1007/s40620-020-00803-3

    authors: Leoncini G,Viazzi F,De Cosmo S,Russo G,Fioretto P,Pontremoli R

    更新日期:2020-10-01 00:00:00

  • The peritoneal sieving of sodium: a simple and powerful test to rule out the onset of encapsulating peritoneal sclerosis in patients undergoing peritoneal dialysis.

    abstract:BACKGROUND AND AIMS:Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodiu...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:10.1007/s40620-016-0371-9

    authors: La Milia V,Longhi S,Sironi E,Pontoriero G

    更新日期:2018-02-01 00:00:00

  • Rubidium deficiency in dialysis patients.

    abstract:BACKGROUND:Since dialysis has brought long-term survival to uremic patients, we can now speculate on more subtle problems derived from imbalance or sub-optimal regulation of some elements such as trace metals. We focused on the rubidium (Rb) status in dialysis patients (HD), as concerns about its possible deficiency ha...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Canavese C,DeCostanzi E,Branciforte L,Caropreso A,Nonnato A,Pietra R,Fortaner S,Jacono F,Angelini G,Gallieni M,Fop F,Sabbioni E

    更新日期:2001-05-01 00:00:00

  • Post-reperfusion rapidly progressive glomerulonephritis in post-transplant IgA nephropathy.

    abstract::Rapidly progressive glomerulonephritis (RPGN) is a rare occurrence in IgA nephropathy (IgAN) in renal transplant patients on immunosuppressive therapy. RPGN post ischemia-reperfusion has not been previously reported. We report a 62 year old male patient on azathioprine therapy, 9 years after left cadaveric renal trans...

    journal_title:Journal of nephrology

    pub_type: 杂志文章

    doi:

    authors: Tovbin D,Shnaider A,Kachko L,Basok A,Vorobiov M,Rogachev B,Abramov D,Zlotnik M

    更新日期:2004-01-01 00:00:00

  • Dietary fat modification in patients with chronic kidney disease: n-3 fatty acids and beyond.

    abstract::Replacement of dietary saturated fat with unsaturated fat has been recommended for prevention of cardiovascular disease (CVD) in the general population. Less is known of the health risks in individuals with chronic kidney disease (CKD), of a diet with an unhealthy fat profile, in general characterized by insufficient ...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:10.5301/jn.5000284

    authors: Huang X,Lindholm B,Stenvinkel P,Carrero JJ

    更新日期:2013-11-01 00:00:00

  • Contrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?

    abstract:INTRODUCTION:Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedu...

    journal_title:Journal of nephrology

    pub_type: 杂志文章,评审

    doi:

    authors: Reddan D,Laville M,Garovic VD

    更新日期:2009-05-01 00:00:00