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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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          Abstract

          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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          Most cited references 5

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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.
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                Author and article information

                Journal
                KBR
                Kidney Blood Press Res
                10.1159/issn.1420-4096
                Kidney and Blood Pressure Research
                S. Karger AG
                1420-4096
                1423-0143
                2001
                2001
                24 January 2001
                : 24
                : 1
                : 71-74
                Affiliations
                Medizinische Klinik I, Universitätsklinik Marienhospital, Ruhr–Universität Bochum, Deutschland
                Article
                54209 Kidney Blood Press Res 2001;24:71–74
                10.1159/000054209
                11174010
                © 2001 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
                Figures: 2, Tables: 1, References: 14, Pages: 4
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/54209
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