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      Pathophysiology and Treatment of Hypertension and Oedema due to Renal Failure

      , , ,

      Cardiology

      S. Karger AG

      Renal failure, Natriuresis, Loop diuretics, Hypertension, Oedema

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          Abstract

          Hypertension and oedema resulting from sodium retention are the main indications for diuretic treatment in patients with chronic renal failure. The pharmacokinetics of most loop diuretics and their active metabolites are altered in chronic renal failure, due both to reduced transtubular transport via the proximal tubular anion transporter and to protein binding within the tubule. In chronic renal failure, the reduced number of nephrons leads to adaptive reduction of tubular sodium reabsorption, i.e. high baseline fractional natriuresis and increased absolute distal tubular sodium reabsorption. These processes interfere with the pharmacodynamic actions of diuretics. Therapeutic strategies to overcome the partial resistance to the action of diuretics in patients with chronic renal failure include the use of high doses, continuous administration and the combination of loop and thiazide compounds.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6001-6
          978-3-318-01948-3
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 84
          : Suppl 2
          : 143-154
          Affiliations
          Department of Internal Medicine, Division of Nephrology, Ruperto Carlo University, Heidelberg, Germany
          Article
          176467 Cardiology 1994;84:143–154
          10.1159/000176467
          7954538
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 12
          Categories
          Renal Failure: Session IV

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