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Dual renin-angiotensin system blockade: in patients with single functioning kidney and proteinuria.
Eur J Intern Med. 2009 Mar; 20(2):186-9.EJ

Abstract

AIM

Dual blockade of renin-angiotensin system (RAS) has increased antiproteinuric effects and it has been increasingly used on patients with proteinuria, but could have secondary effects when this kind of treatment is administered to patients with single functioning kidney. The aim of this study has been to assess the efficacy and safety of dual blockade of RAS in this group of patients.

DESIGN AND METHODS

Sixteen patients with a single functioning kidney have been treated in our unit with dual RAS blockade due to proteinuria higher than 1 g/24 h. Mean age was 54.7+/-12.1 years, they were 12 males and 4 females. Analytical data of six months visit and last follow up visit have been retrospectively registered. Several different angiotensin conversor enzyme (ACE) inhibitors and angiotensin receptor blocking (ARB) drugs were used at the maximal dose tolerated by the patient.

RESULTS

A small but not significant reduction of SBP and DBP were was observed throughout the study. Mean K+ increase in the second visit (from 4.65+/-0.67 to 5.01+/-1.02 mmol/l, not significant). There were no changes neither in plasmatic creatinine (baseline 1.86+/-0.67, 6 months 1.96+/-0.85) nor in creatinine clearance (baseline 65.2+/-26.9, 6 months 61.6+/-23.8 ml/min). Proteinuria was not reduced by dual RAS blockade (baseline 4.26+/-0.24, 6 months 4.25+/-0.39).

CONCLUSIONS

Dual RAS blockade seems to be safe but unhelpful in renal patients with proteinuria associated to single functioning kidney.

Authors+Show Affiliations

Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, Spain. nroblesp@senefro.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19327610

Citation

Robles, N R., et al. "Dual Renin-angiotensin System Blockade: in Patients With Single Functioning Kidney and Proteinuria." European Journal of Internal Medicine, vol. 20, no. 2, 2009, pp. 186-9.
Robles NR, Ruiz Jiménez B, Hernández Gallego R, et al. Dual renin-angiotensin system blockade: in patients with single functioning kidney and proteinuria. Eur J Intern Med. 2009;20(2):186-9.
Robles, N. R., Ruiz Jiménez, B., Hernández Gallego, R., Ruiz-Calero, R., Sánchez Casado, E., & Cubero, J. J. (2009). Dual renin-angiotensin system blockade: in patients with single functioning kidney and proteinuria. European Journal of Internal Medicine, 20(2), 186-9. https://doi.org/10.1016/j.ejim.2008.06.002
Robles NR, et al. Dual Renin-angiotensin System Blockade: in Patients With Single Functioning Kidney and Proteinuria. Eur J Intern Med. 2009;20(2):186-9. PubMed PMID: 19327610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dual renin-angiotensin system blockade: in patients with single functioning kidney and proteinuria. AU - Robles,N R, AU - Ruiz Jiménez,B, AU - Hernández Gallego,R, AU - Ruiz-Calero,R, AU - Sánchez Casado,E, AU - Cubero,J J, Y1 - 2008/07/23/ PY - 2007/07/06/received PY - 2008/05/28/revised PY - 2008/06/09/accepted PY - 2009/3/31/entrez PY - 2009/3/31/pubmed PY - 2009/6/19/medline SP - 186 EP - 9 JF - European journal of internal medicine JO - Eur J Intern Med VL - 20 IS - 2 N2 - AIM: Dual blockade of renin-angiotensin system (RAS) has increased antiproteinuric effects and it has been increasingly used on patients with proteinuria, but could have secondary effects when this kind of treatment is administered to patients with single functioning kidney. The aim of this study has been to assess the efficacy and safety of dual blockade of RAS in this group of patients. DESIGN AND METHODS: Sixteen patients with a single functioning kidney have been treated in our unit with dual RAS blockade due to proteinuria higher than 1 g/24 h. Mean age was 54.7+/-12.1 years, they were 12 males and 4 females. Analytical data of six months visit and last follow up visit have been retrospectively registered. Several different angiotensin conversor enzyme (ACE) inhibitors and angiotensin receptor blocking (ARB) drugs were used at the maximal dose tolerated by the patient. RESULTS: A small but not significant reduction of SBP and DBP were was observed throughout the study. Mean K+ increase in the second visit (from 4.65+/-0.67 to 5.01+/-1.02 mmol/l, not significant). There were no changes neither in plasmatic creatinine (baseline 1.86+/-0.67, 6 months 1.96+/-0.85) nor in creatinine clearance (baseline 65.2+/-26.9, 6 months 61.6+/-23.8 ml/min). Proteinuria was not reduced by dual RAS blockade (baseline 4.26+/-0.24, 6 months 4.25+/-0.39). CONCLUSIONS: Dual RAS blockade seems to be safe but unhelpful in renal patients with proteinuria associated to single functioning kidney. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/19327610/Dual_renin_angiotensin_system_blockade:_in_patients_with_single_functioning_kidney_and_proteinuria_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(08)00178-7 DB - PRIME DP - Unbound Medicine ER -