Interní Med. 2010; 12(5): 270-274

Léčba hypertenze u renální insuficience a dialýzy

prof.MUDr.Vladimír Tesař, DrSc.
Nefrologické oddělení I. interní kliniky 1. LF UK a VFN, Praha

Renální onemocnění je často provázeno hypertenzí, která přispívá k progresi chronické

renální insuficience a dále zvyšuje kardiovaskulární riziko těchto pacientů. Cílový krevní

tlak je u pacientů s renálním onemocněním nižší než u běžné populace. Lékem volby jsou

inhibitory angiotenzin konvertujícího enzymu nebo antagonisté angiotenzinu. Hypertenze

je často těžká, obtížně kontrolovatelná monoterapií, a vyžaduje proto obvykle kombinační

léčbu. Hypertenze u dialyzovaných pacientů je obvykle významně volum-dependentní

a kontrolu hypertenze lze u většiny pacientů výrazně zlepšit snížením suché váhy.

Keywords: hypertenze, renální insuficience, selhání ledvin, dialýza

Published: June 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Tesař V. Léčba hypertenze u renální insuficience a dialýzy. Interní Med. 2010;12(5):270-274.

Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Lewis EJ, Hunsicker LG, Bain RP, et al. The effect of angiotensin converting enzyme inhibition on diabetic nephropathy. N. Engl. J. Med. 1993; 329: 1456-1462. Go to original source... Go to PubMed...
    2. Villarosa IP, Bakfiš GL. Antihypertensive therapy in type 2 diabetes with nephropathy. In: Ritz E, Rychlík I. Nephropathy in type 2 diabetes. Oxford University Press, Oxford, 1999: 111-136. Go to original source...
    3. Bakris GL, et al. Effects of blood pressure level on progression of diabetic nephropathy. Arch Intern Med 2003; 163: 1555-1565. Go to original source... Go to PubMed...
    4. Lazarus JM, Bourgoignie JJ, Buckalew VM, et al. Achievement and safety of a low blood pressure goal in chronic renal disease. Hypertension 1997; 29: 641-650. Go to original source... Go to PubMed...
    5. Chobanian AV, Bakfiš GL, Blafl HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA 2003; 289: 2560-2572. Go to original source... Go to PubMed...
    6. Guidelines Committee: 2003 European Society of Hypertension - European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011-1053. Go to original source... Go to PubMed...
    7. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N. Engl. J. Med. 2001; 345: 851-860. Go to original source... Go to PubMed...
    8. The GISEN Group: Randomized placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. Lancet 1997; 349: 1857-1863. Go to original source...
    9. Bakris GI, Ruilpe L, Locatelli F, et al. Treatment of microalbuminuria in hypertensive subjects with elevated cardiovascular risk: results of the IMPROVE trial. Kidney Int. 2007; 72: 879-885. Go to original source... Go to PubMed...
    10. Parving HH, Persson F, Lewis JB, et al. Aliskiren combined with losartan in type 2 diabetes and nephropathy. N. Engl. J. Med. 2008; 358: 2433-2446. Go to original source... Go to PubMed...
    11. Schwenger V, Ritz E. Audit of antihypertensive treatment in patients with renal failure. Nephrol. Dial. Transplant. 1998; 13: 3091-3095. Go to original source... Go to PubMed...
    12. Levey AS, Beto JA, Coronado BE, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we know? What do we need to learn? Where do we go from here? Am. J. Kidney Dis. 1998; 32: 853-906. Go to original source... Go to PubMed...
    13. Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N. Engl. J. Med. 1998; 338: 645-652. Go to original source... Go to PubMed...
    14. Tatti P, Pahor M, Byington R, et al. Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21: 597-602. Go to original source... Go to PubMed...
    15. Berl T, et al. Cardiovascular outcomes in the irbesartan diabetic nephropathy trial of patients with type 2 diabetes and overt nephropathy. Ann Intern Med 2003; 138: 542-549. Go to original source... Go to PubMed...
    16. Zannad Z, Kessler M, Lehert P, et al. Prevention of cardiovascular events in end-stage renal disease: results of a randomized trial of fosinopril and implications for future studies. Kidney Int. 2006; 70: 1318-1324. Go to original source... Go to PubMed...
    17. Cice G, Ferrari L, D´Andrea A, et al. Carvedilol increases two-year survival in dialysis patients with dilated cardiomyopathy, a prospective placebo-controlled trial. J. Am. Coll. Cardiol. 2003; 41: 1438-1444. Go to original source... Go to PubMed...

    Return to the content


    Internal Medicine for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.