Effect of renin-angiotensin system inhibitors in diabetic dialysis patients with chronic heart failure

DOI Web Site 36 References

Bibliographic Information

Other Title
  • 糖尿病透析慢性心不全に対するレニン・アンジオテンシン系抑制薬の効果
  • トウニョウビョウ トウセキ マンセイ シンフゼン ニ タイスル レニン アンジオテンシンケイ ヨクセイヤク ノ コウカ

Search this article

Abstract

The effectiveness of renin-angiotensin system inhibitors (RA inhibitors) in chronic systolic heart failure (HF) was established. In dialysis therapy, an appropriate dry weight (DW) must be maintained, especially for HF patients. The numbers of diabetic patients have been increasing among patients starting dialysis. In diabetics, especially those with HF, blood pressure (BP) can be unstable during dialysis, which may make it difficult to maintain DW. RA inhibitors may be helpful in diabetic dialysis patients with chronic HF (CHF). RA inhibitors have not been sufficiently studied in dialysis patients, to date. We studied the effectiveness of RA inhibitors in diabetic CHF patients on maintenance dialysis therapy, with a left ventricular ejection fraction (LVEF) less than 50%. The cohort included seven male patients with an average age of 64.4±8.7 years and a BMI of 22.0±2.9 kg/m2. The average duration of diabetes was 10.9±11.4 years, and HbA1c was 6.5±1.6%. Two patients used diet therapy ; four patients, oral hypoglycemic agents ; and one patient was treated with insulin. The average duration of dialysis was 49.7±44.3 months. Six patients had ischemic heart disease, and one patient had dilated cardiomyopathy. One patient was prescribed enalapril ; one, losartan ; three, valsartan ; and two, telmisartan. RA inhibitors were gradually increased to 82.1±24.9% of the target dose. Duration of treatment and observation was 12.6±8.8 months. DW increased from 57.6±7.6 to 61.5±8.3 kg after treatment. CTR decreased from 52.3±4.5 to 48.9±5.3%. LAD decreased from 45.7±6.4 to 39.7±6.7mm. LVDd decreased from 60.9±3.2 to 52.2±5.5 mm. LVEF showed a notable improvement from 39.8±8.0 to 55.0±8.6%. BP and pulse rate did not show any significant change. Following treatment with RA inhibitors, despite a DW increment, CTR decreased and LV function improved in diabetic dialysis patients with CHF.

Journal

References(36)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top