Effect of irbesartan combined with hemodialysis on renal hemodynamics in patients with renal proteinuria / 中国医师杂志

ABSTRACT

Objective To explore the effects of irbesartan combined with hemodialysis on renal function,inflammatory factors and renal hemodynamics in patients with renal proteinuria.Methods A total of 106 patients with renal proteinuria who underwent hemodialysis in Changzheng Hospital Affiliated to Naval Medical University from May 2016 to May 2018 were selected for the study and were divided into observation group and control group according to the random number table method.The two groups were given hemodialysis,and observation group was given irbesartan on this basis.Kidney-related examination indexes [24 h urine protein quantitation,24 h urine volume,serum creatinine (Scr),urea nitrogen (BUN)],inflammatory factors [C-reactive protein (CRP),interleukin-8 (IL-8),intercellular adhesion molecule-1 (ICAM-1),monocyte chemoattractant protein-1 (MCP-1)],bilateral renal interlobar artery resistance index (RI),hemorheology (whole blood viscosity,low-shear viscosity,high-shear viscosity,erythrocyte aggregation index)were observed in the two groups before and after treatment.Results After 3 months of treatment,the levels of urine protein quantitation,serum Scr,BUN,CRP,IL-8,ICAM-1 and MCP-1 in the two groups were lower than those before treatment,and the levels in observation group were lower than those in control group (P ＜ 0.05);the 24h urine volume was more than that before treatment,and the level in observation group was more than that in control group (P ＜ 0.05).The RI values of bilateral kidney in the two groups were lower than those before treatment,and the value in observation group was lower than that in control group (P ＜ 0.05).The whole blood viscosity,low-shear viscosity,high-shear viscosity and erythrocyte aggregation index in the two groups were lower than those before treatment,and the indexes in observation group were lower than those in control group (P ＜ 0.05).Conclusions Addition of irbesartan in patients with renal proteinuria treated by hemodialysis can effectively improve renal function,reduce inflammation and blood viscosity,and improve renal hemodynamics,and promote the disease outcomes.