Losartan in dialysis patients

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The duration of participation in the study per subject, which according to the trial design could be up to 12 months, was determined. Roudebush Veterans AdministrationMedical Center.

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The extreme changes in blood volume often make it difficult to obtain a clear picture of the actual blood pressure in haemodialysis patients. Lisinopril therapy for hemodialysis hypertension: Losartan was withdrawn in only 6 patients because of a clinical or laboratory adverse experience. In a subgroup analysis of this trial, the reverse was found to be true among blacks. At the request of the data safety and monitoring board, we also calculated the hospitalization rates by treatment and their confidence intervals.

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It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. However, in hemodialysis patients requiring multiple antihypertensive agents to control blood pressure, these agents can be safely used and do not require additional dosing with hemodialysis. Fluid balance is an integral part of the management of haemodialysis patients, to prevent under- or over-hydration, which are associated with cardiovascular and other complications 7.

The precise mechanism by which BP is reduced in this patient population is not elucidated by this study; however, it is possible that inhibition of angiotensin II receptors on vascular tissue and in the kidney, heart, and sympathetic nervous system contribute to the antihypertensive effect. In the total population, laboratory abnormalities that were considered drug related by the investigator were reported in 18 patients While this drug combination maybe effective, the major limitation is compliance because of thrice daily dosing and a pill burden of atleast six pills.

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Competitive effects of hypokalemia and volume depletion on plasma renin activity, aldosterone and catecholamine concentrations in hemodialysis patients. If BP control was not possible felodipine or amlodipine 10 mg QD once daily was added, followed by other antihypertensive therapies in the following order: All analyses were conducted using Stata version Reduction in overall blood pressure would not only lead to an increase in overall survival rates but also improve the quality of life among ESRD patients.

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How to cite this article: Intradialytic hypertension, a less recognized cardiovascular complication of hemodialysis. Renin angiotensin aldosterone system RAAS activation has been identified as one of the major contributors. Plasma concentrations of E, however, are not significantly altered in patients with renal impairment or in patients undergoing hemodialysis.

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A permuted block design was chosen to avoid imbalance in assignment to the study drugs over time. If patients were treated with antihypertensive medications, these medications were tapered and home BP obtained every week up to a maximum of 3 weeks.

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These agents should be avoided in patients with intradialytic hypotension and should not be used in combination with midodrine because of its counteracting effects on alpha adrenergic stimulation. Beta-blocker use in long-term dialysis patients:

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