Augmented antihypertensive effect of a fixed combination formula of candesartan and hydrochlorothiazide combined with furosemide in a patient on peritoneal dialysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Satoru Kuriyama Yasushi Otsuka Hiroyuki Ueda Naoki Sugano Takeo Yoshizawa Taku Yamada Tatsuo Hosoya
- چاپ و سال / کشور: 2011
Description
A 38-year-old female patient on peritoneal dialysis (PD) due to type 1 diabetic nephropathy with a wellpreserved residual renal function did not respond well to the conventional antihypertensive therapy consisting of candesartan, furosemide, and bunazosin. Switching candesartan for a fixed combination formula of candesartan plus hydrochlorothiazide (HCTZ) while the rest of the other two agents remained unchanged led to the remarkable reduction in both systolic and diastolic blood pressure (BP) without significant changes in the cardiothoracic ratio (CTR), body weight (BW), and residual renal function. This case suggests that when used in combination, diuretics acting on different functional segment of the nephron hold greater potential for enhanced antihypertensive effect, especially in patients on PD whose residual renal function is well preserved. A small dose of HCTZ with an angiotensin II receptor blocker (ARB) may partially explain the therapeutic benefit of this combination therapy in terms of a reliable hypotensive effect, a better adherence, and fewer side effects.
Clin Exp Nephrol (2011) 15:175–178, Received: 12 May 2010 / Accepted: 19 September 2010 / Published online: 20 October 2010 Japanese Society of Nephrology 2010
