Prescripción de fármacos bloqueadores del sistema renina angiotensina en pacientes con enfermedad renal crónica etapa 3 en atención primaria de salud / Prescription of renin-angiotensin-aldosterone system blockers in patients with stage 3 chronic kidney disease
Rev. méd. Chile
;
147(2): 173-180, Feb. 2019. tab, graf
Article
in Spanish
| LILACS
| ID: biblio-1004330
ABSTRACT
Background:
To reduce the progression of chronic kidney disease (CKD) and cardiovascular risk, the guidelines recommend the blockade of the renin-angiotensin-aldosterone system (RAAS) in patients with proteinuria.Aim:
To assess the frequency of enalapril or losartan use in diabetics or hypertensive patients with stage 3 CKD. Material andMethods:
Review of clinical records of patients with CKD in an urban primary care clinic.Results:
We identified 408 subjects aged 40 to 98 years (66% women) with stage 3 CKD. Sixty six percent had only hypertension and 34% were diabetic with or without hypertension. Seventy four percent received RAAS blockers (52% used enalapril, 45% losartan and 2% both medications). RAAS blockers were used in 70% of hypertensive and 78% of diabetic patients. The prescription in hypertensive diabetics with microalbuminuria was lower than in those without microalbuminuria (72% vs 87%, p < 0.05), but the opposite occurred in pure hypertensive patients with and without microalbuminuria (88% vs 69%, p < 0.05). There were no significant differences in blood pressure levels, microalbuminuria or serum potassium levels between RAAS blocker users and non-users. No differences were observed either between enalapril and losartan users.Conclusions:
The adherence to clinical guidelines is insufficient and users of the recommended drugs did not achieve the expected goals.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Angiotensin-Converting Enzyme Inhibitors
/
Enalapril
/
Losartan
/
Renal Insufficiency, Chronic
Type of study:
Practice guideline
/
Prognostic study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Universidad Austral de Chile/CL
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