ABSTRACT
The effects of two beta-adrenoceptor blockers, the beta1-selective metoprolol and the non-selective propranolol, was studied in high renin patients (n = 15) with very high pretreatment blood pressures. Ten of the patients had essential hypertension and five renal artery stenosis. From high blood pressure values after six weeks on placebo, there was a pronounced drop in both supine and standing blood pressures in both groups with a small to moderate dose of beta-blocker, thus showing that the good blood pressure control in high renin patients is not connected to blockade of beta2-receptors or to the aetiology of the hypertension. In patients with essential hypertension who were treated with metoprolol, a significant positive correlation (r = 0.66, n = 10) was also found between the fall in blood pressure and the fall in plasma renin activity. Values for glomerular filtration rate (GFR) before and after treatment were unchanged throughout the whole spectrum of GFR from those values indicating substantially decreased kidney function up to normal values.
Subject(s)
Hypertension/drug therapy , Metoprolol/therapeutic use , Propanolamines/therapeutic use , Propranolol/therapeutic use , Renin/blood , Adult , Clinical Trials as Topic , Female , Glomerular Filtration Rate , Humans , Hypertension/blood , Hypertension, Renal/drug therapy , Hypertension, Renal/etiology , Male , Middle Aged , Renal Artery Obstruction/complicationsABSTRACT
In 14 nondialyzed patients with chronic renal failure (CRF) and at the start of treatment a glomerular filtration rate (GFR) of 14--47 ml/min changes in bone mineral mass (BMM), expressed in percentage of the initial value, showed a significant correlation with the mean GFR during an observation period of 16 +/- 2 mo. During a predialysis period of 6 mo BMM decreased to 97.8 +/- 3.2% of the original value in 9 patients, while after 6, 12, and 16 mo of dialysis treatment, BMM in the same patients fell to 94.5 +/- 3.0%, 92.0 +/- 3.2% and 91.8 +/- 4.6% of the initial value. As after the onset of regular hemodialysis the fractional intestinal absorption of 47Ca does not decrease but even increases in most patients, the importance of the level of intestinal calcium absorption for the development of dialysis bone disease may be questioned.
Subject(s)
Bone and Bones/metabolism , Calcium/metabolism , Intestinal Absorption , Kidney Failure, Chronic/metabolism , Adult , Female , Glomerular Filtration Rate , Humans , Kidney/physiopathology , Kidney Failure, Chronic/physiopathology , MaleABSTRACT
In 34 patients with chronic renal failure (CRF), fractional 47calcium absorption (Fa47Ca) was measured by an external counting method. A significant correlation was found with impairment of renal function, as expressed by the creatinine clearance. There was also a significant correlation of Fa47Ca with the serum phosphate (SeP) level and of immunoreactive parathyroid hormone (iPTH) with renal function. When the relationship of both SeP and Fa47Ca with creatinine clearance was excluded, no partial correlation between SeP and Fa47Ca appeared to exist. A significant increase of Fa47Ca and serum Ca and a significant decrease of SeP and iPTH were found in 12 patients 2 to 15 months after they were put on intermittent hemodialysis. The possible influence of SeP on intestinal calcium absorption is discussed, and it is suggested that impairment of intestinal absorption of calcium is not a main factor in development of renal osteodystrophy.
