| The dual blockade of the renin-angiotensin system in hemodialysis patients requires decreased dialysate sodium concentration. | |
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MedLine Citation:
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PMID: 23136031 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The study evaluated whether the dual blockade of the renin-angiotensin system may influence the sodium balance in hemodialysis. METHODS: The study involved 148 hemodialysis patients (male 85, female 63), mean age 59.6 ± 12.9 years. Participants were randomly selected to receive either angiotensin-converting enzyme inhibitor (ACEI)-subgroup A-or dual blockade ACEI and angiotensin receptor blocker (ARB)-subgroup AA. RESULTS: At baseline, in the A versus AA subgroups, the pre-dialysis sodium concentrations (mmol/l) were 137.7 ± 0.5 versus 137.9 ± 0.8, the sodium gradients 2.6 ± 0.5 versus 2.9 ± 0.4, interdialytic weight gain (IWG) (kg) 3.1 ± 0.2 versus 3.0 ± 0.3, and thirst inventory score (points) 18.1 ± 1.0 versus 19.0 ± 1.7, respectively. After 3 months of therapy, a decrease in sodium concentration to 134.5 ± 0.5 and the increase of its gradient to 5.5 ± 0.5 were noted in the AA subgroup. An elevation of mean interdialytic weight gain to 3.47 ± 0.2 and thirst score to 21.3 ± 2.1 was observed. No significant changes in subgroup A were found. One month of the dialysate sodium concentration being lowered from 140 mmol/l to 138 mmol/l was associated with reduced serum sodium concentration and gradient, decreased IWG and restored moderate thirst score in the AA subgroup (137.5 ± 0.6 and 2.9 ± 0.6, 3.0 ± 0.5 and 19.2 ± 1.3, respectively). CONCLUSIONS: The dual blockade of the renin-angiotensin system affects sodium balance, increasing the sodium gradient, thus elevating thirst sensation and enhancing interdialytic weight gain. In maintenance hemodialysis patients treated with both ACEI and ARB, lowered dialysate sodium levels should be prescribed. |
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Authors:
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Rafał Zwiech; Agnieszka Bruzda-Zwiech |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-8 |
Journal Detail:
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Title: International urology and nephrology Volume: - ISSN: 1573-2584 ISO Abbreviation: Int Urol Nephrol Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0262521 Medline TA: Int Urol Nephrol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Kidney Transplantation, Dialysis Department, Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, Kopcinskiego 22, 90-153, Lodz, Poland, rzwiech@mp.pl. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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