Effect of renin-angiotensin system inhibitors in diabetic dialysis patients with chronic heart failure
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- Nashiro Kazutaka
- Department of Internal Medicine, Nakagami Hospital
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- Maekawa Youko
- Department of Internal Medicine, Nakagami Hospital
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- Shimajiri Tsuyako
- Department of Internal Medicine, Chibana Clinic
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- Tokashiki Kaori
- Department of Internal Medicine, Nakagami Hospital
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- Shimoji Youko
- Department of Internal Medicine, Chibana Clinic
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- Yara Tomohiro
- Department of Internal Medicine, Nakagami Hospital
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- Nakazato Satoshi
- Department of Internal Medicine, Chibana Clinic
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- Shiroma Isao
- Department of Internal Medicine, Chibana Clinic
Bibliographic Information
- Other Title
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- 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
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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
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 42 (2), 151-157, 2009
The Japanese Society for Dialysis Therapy
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Keywords
Details 詳細情報について
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- CRID
- 1390001204678207232
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- NII Article ID
- 10024930345
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 10190597
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed