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Titolo:
A random comparison of fosinopril and nifedipine GITS in patients with primary renal disease
Autore:
Marin, R; Ruilope, LM; Aljama, P; Aranda, P; Segura, J; Diez, J;
Indirizzi:
Hosp Covadonga, Serv Nefrol, Oviedo 33006, Spain Hosp Covadonga Oviedo Spain 33006 onga, Serv Nefrol, Oviedo 33006, Spain Hosp 12 Octubre, Unidad Hipertens, E-28041 Madrid, Spain Hosp 12 Octubre Madrid Spain E-28041 ad Hipertens, E-28041 Madrid, Spain Hosp Reina Sofia, Serv Nefrol, Cordoba, Spain Hosp Reina Sofia Cordoba Spain Reina Sofia, Serv Nefrol, Cordoba, Spain Hosp Reg Carlos Haya, Serv Nefrol, Malaga, Spain Hosp Reg Carlos Haya Malaga Spain rlos Haya, Serv Nefrol, Malaga, Spain Fac Med Pamplona, Inst Invest Biomed, Pamplona, Spain Fac Med Pamplona Pamplona Spain na, Inst Invest Biomed, Pamplona, Spain
Titolo Testata:
JOURNAL OF HYPERTENSION
fascicolo: 10, volume: 19, anno: 2001,
pagine: 1871 - 1876
SICI:
0263-6352(200110)19:10<1871:ARCOFA>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVERTING ENZYME-INHIBITION; BLOOD-PRESSURE CONTROL; NONDIABETIC NEPHROPATHIES; NEPHROTIC PROTEINURIA; CONTROLLED TRIAL; PROGRESSION; INSUFFICIENCY; ENALAPRIL; BLOCKERS; FAILURE;
Keywords:
calcium channel blockers; chronic renal failure; converting enzyme inhibitors; creatinine clearance; fosinopril; nifedipine GITS; proteinuria;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Marin, R Hosp Covadonga, Serv Nefrol, Celestino Villamil S-N, Oviedo 33006, Spain Hosp Covadonga Celestino Villamil S-N Oviedo Spain 33006 , Spain
Citazione:
R. Marin et al., "A random comparison of fosinopril and nifedipine GITS in patients with primary renal disease", J HYPERTENS, 19(10), 2001, pp. 1871-1876

Abstract

Objective To investigate in a random comparison the capacity of an angiotensin converting enzyme inhibitor (fosinopril), and that of a long-acting dihydropiridine (nifedipine GITS) to modify the decay in renal function in patients with primary renal disease, exhibiting a progressive increase in serum creatinine during the previous 2 years. Methods A randomized, open-label, multicenter study with a minimum follow-up of 3 years. A total of 241 patients were included in the study. All of them were hypertensive and had a 25% or at least 0.5 mg/dl increase in the value of serum creatinine during the 24 months prior to entering the study. Initial doses of fosinopril and nifedipine GITS were 10 and 30 mg respectively, and titration to 30 and 60 mg was performed if needed to obtain the expected blood pressure goal (< 140/90 mmHg). Furosemide, atenolol, and doxazosin were added as second, third, and fourth drugs if necessary, for blood pressure control. The primary end-point of the study was the appearance of double the serum creatinine values and/or the need to enter a dialysis programme. Secondary end-points were cardiovascular events, death, changes in 24 h proteinuria, and the evolution of serum creatinine. Data reflect the analysis performed by intention to treat. Results Mean age of the group was 54 +/- 14, and 59% were males. Primary glomerulonephritis (31 %), nephrosclerosis (26%) and polycystic kidney disease (19%) were the three most frequent diagnostic findings. After 3 years offollow-up, 21% (27/127) of patients treated with fosinopril, and 36% (40/112) of those receiving nifedipine GITS presented a primary end-point, (OR 0.47, 95% confidence intervals 0.26-0.84, P = 0.01). Renal survival was significantly better when fosinopril constituted the first step therapy (P = 0.002). These results did not seem to be influenced by the type of primary renal disease. Proteinuria decreased at the end of the study by a mean of 57%in the fosinopril group and increased by 7% in the group receiving dihydropiridine. Blood pressure control did not differ among groups for diastolic values. During followup, however, the patients receiving ACEi showed systolic blood pressure values 4-6 mmHg lower. Conclusion In patients with chronic renal failure and hypertension due to primary renal disease, fosinopril significantly differed from nifedipine GITS by its capacity to slow the progressive decay in renal function. The drugs also differed by their capacity to lower blood pressure. The better control, in particular of systolic blood pressure, in the fosinopril arm could have contributed in a relevant manner to the attainment of a better outcomewhen the ACE was employed. (C) 2001 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 10:08:34