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      Efficacy and Tolerability of Angiotensin II Type 1 Receptor Antagonists in Dialysis Patients Using AN69 Dialysis Membranes

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          Aims and Methods: Our aim was to evaluate the antihypertensive efficacy and tolerability of angiotensin II type 1 (AT<sub>1</sub>) receptor antagonists. Valsartan or candesartan cilexetil was administered to 11 dialysis patients with elevated blood pressure. The patients (6 male, 5 female; mean age ± SD 61±11 years) were on regular bicarbonate hemodialysis three times weekly for more than 3 months using acrylonitrile and sodium methallyl sulfonate copolymer (AN69) dialysis membranes. Results: Within 252 days after administration of the AT<sub>1</sub> receptor antagonists the systolic blood pressure was significantly reduced from 161±13 to 130±12 mmHg (p<0.001), whereas the diastolic blood pressure did not change significantly (76±8 vs. 71±8 mmHg; p>0.05). In addition, heart rate (75±7 vs. 80±8/min), body weight, and laboratory variables (hemoglobin, creatinine, blood urea nitrogen, serum potassium, serum sodium, serum calcium, and total protein) showed no significant changes. During 1,188 hemodialysis sessions using AN69 membranes, no hypersensitivity reactions occurred after administration of AT<sub>1</sub> receptor antagonists. Conclusion: The results indicate that once–daily administration of AT<sub>1</sub> receptor antagonists efficiently reduces the systolic blood pressure in hemodialysis patients.

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          Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure

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            Care of patients undergoing hemodialysis.

             O Ifudu (1998)
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              Angiotensin II receptor inhibition. A new therapeutic principle.

              Angiotensin II receptor antagonists represent a new class of drugs that provide a site-specific blockade of the effects of angiotensin II. Losartan potassium, the first compound of this drug class, has recently become available in the United States. The clinical experience with angiotensin II receptor antagonists has demonstrated that these drugs are safe and efficacious for the treatment of hypertension and, possibly, congestive heart failure. Unlike with angiotensin-converting enzyme inhibitors, the incidence of cough observed with angiotensin receptor antagonists is similar to that with placebo. Although several angiotensin receptors have been characterized, the effects of losartan and other angiotensin receptor antagonists under development are selective for the angiotensin II type 1 receptor. Unlike angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists do not inhibit bradykinin metabolism or enhance prostaglandin synthesis. The antihypertensive efficacy of the angiotensin receptor antagonists has been documented to be similar to that of angiotensin-converting enzyme inhibitors. If the findings of clinical studies corroborate the initial reports on efficacy and safety, it seems likely that the angiotensin receptor antagonists will be added to the list of drugs that have been deemed suitable for first-line therapy in the treatment of hypertension and congestive heart failure.

                Author and article information

                Kidney Blood Press Res
                Kidney and Blood Pressure Research
                S. Karger AG
                24 January 2001
                : 24
                : 1
                : 71-74
                Medizinische Klinik I, Universitätsklinik Marienhospital, Ruhr–Universität Bochum, Deutschland
                54209 Kidney Blood Press Res 2001;24:71–74
                © 2001 S. Karger AG, Basel

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                Page count
                Figures: 2, Tables: 1, References: 14, Pages: 4
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/54209
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