RESUMO
The effect of propranolol therapy on plasma renin activity and blood pressure control was evaluated in 35 uremic patients receiving intermittent center-based outpatient hemodialysis. Patients were determined to be either compliant or noncompliant with therapy based on the steady-state predialysis plasma propranolol concentration. Noncompliance occurred with remarkable frequency and was associated with persistent hyperreninemia and poorly controlled hypertension. Blood pressure control was significantly better in compliant patients, in whom plasma renin activity was generally, but not universally, suppressed. Propranolol can be effectively used in the management of hypertensive dialysis patients, but steady-state plasma propranolol levels should be measured to assess compliance in patients apparently refractory to treatment.
Assuntos
Hipertensão/tratamento farmacológico , Cooperação do Paciente , Propranolol/uso terapêutico , Diálise Renal , Uremia/terapia , Adolescente , Adulto , Idoso , Pressão Sanguínea , Feminino , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Renina/sangue , Uremia/complicaçõesAssuntos
Falência Renal Crônica/metabolismo , Propranolol/metabolismo , Feminino , Meia-Vida , Hematócrito , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etiologia , Falência Renal Crônica/complicações , Masculino , Propranolol/administração & dosagem , Propranolol/efeitos adversos , Propranolol/sangue , Propranolol/uso terapêutico , Propranolol/urina , Radioimunoensaio , Diálise Renal , Renina/sangue , Espectrometria de Fluorescência , Fatores de TempoRESUMO
X-ray microanalysis was employed to define the cation content of electron-dense pyroantimonate complexes that occur in the proximal tubule of the rat kidney, along the intracellular aspect of plasma membranes and within the interchromatin regions of cell nuclei, when exposed to potassium pyroantimonate [KSb(OH)(6)] in vivo. Standard micropuncture technics were utilized to perfuse single proximal tubules in vivo with KSb(OH)(6) before fixation with a glutaraldehyde-formaldehyde fixative. Unstained, 1000 A-thin sections cut from Epon-embedded material were viewed directly with transmission electron microscopy and then subjected to x-ray microanalysis to determine their elemental content. Calcium, magnesium and potassium ions, in addition to sodium ions, were also present within the electron dense pyroantimonate complexes. Heavy concentrations of potassium and antimony in unrinsed tissue, presumably in the form of KSb(OH)(6). complexes, probably resulted from nonspecific precipitation secondary to exposure to alcohol solutions during dehydration, since KSb(OH)(6), is insoluble in alcohol.
