Short and Long-Term Effects of the Angiotensin II Receptor Blocker Irbesartan on Intradialytic Central Hemodynamics: A Randomized Double-Blind Placebo-Controlled One-Year Intervention Trial (the SAFIR Study).
Short and Long-Term Effects of the Angiotensin II Receptor Blocker Irbesartan on Intradialytic Central Hemodynamics: A Randomized Double-Blind Placebo-Controlled One-Year Intervention Trial (the SAFIR Study).
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DOI：
10.1371/journal.pone.0126882
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Jespersen B
中科院分区：
文献类型：
--
作者：
Peters CD;Kjaergaard KD;Jensen JD;Christensen KL;Strandhave C;Tietze IN;Novosel MK;Bibby BM;Jespersen B
关于血液透析治疗期间抗高血压药物的耐受性知之甚少。本研究评估了血管紧张素 II 受体阻滞剂 (ARB) 厄贝沙坦的使用。随机、双盲、安慰剂对照、为期一年的干预试验。 82 名尿量>300 mL/天且透析年份<1 年的血液透析患者。厄贝沙坦/安慰剂 300 mg/天，持续 12 个月，作为抗高血压治疗的补充，所有患者的透析前收缩压目标为 140 mmHg。心输出量、每搏输出量、中心血容量、总外周阻力、平均动脉压和透析中低血压的频率。在基线时，各组在年龄、合并症、血压、抗高血压药物、超滤量和透析参数方面相似。在一年期间，透析前收缩压显着下降，但两组的情况相似。两组的平均开始和平均结束心输出量、每搏输出量、总外周阻力、心率和平均动脉压稳定且相似，而中心血容量随着时间的推移略有增加，但相似。透析期间观察到的平均血流动力学反应是心输出量、每搏输出量、平均动脉压和中心血容量下降，而心率增加。总外周阻力没有显着变化。总体而言，随着时间的推移，两组的这种模式都保持稳定，并且不受 ARB 治疗的影响。透析期间低血压发作的总数为（安慰剂/ARB）50/63（P = 0.4）。在基于基线参数的多变量逻辑回归分析中，超滤量、左心室质量指数、血浆白蛋白和透析中总外周阻力的变化与透析中低血压显着相关。使用ARB厄贝沙坦作为其他抗高血压治疗的补充，无论是短期还是长期，都不会显着影响透析中的血流动力学，并且没有观察到低血压发作的显着增加。临床试验.gov NCT00791830
Little is known about the tolerability of antihypertensive drugs during hemodialysis treatment. The present study evaluated the use of the angiotensin II receptor blocker (ARB) irbesartan. Randomized, double-blind, placebo-controlled, one-year intervention trial. Eighty-two hemodialysis patients with urine output >300 mL/day and dialysis vintage <1 year. Irbesartan/placebo 300 mg/day for 12 months administered as add-on to antihypertensive treatment using a predialytic systolic blood pressure target of 140 mmHg in all patients. Cardiac output, stroke volume, central blood volume, total peripheral resistance, mean arterial blood pressure, and frequency of intradialytic hypotension. At baseline, the groups were similar regarding age, comorbidity, blood pressure, antihypertensive medication, ultrafiltration volume, and dialysis parameters. Over the one-year period, predialytic systolic blood pressure decreased significantly, but similarly in both groups. Mean start and mean end cardiac output, stroke volume, total peripheral resistance, heart rate, and mean arterial pressure were stable and similar in the two groups, whereas central blood volume increased slightly but similarly over time. The mean hemodynamic response observed during a dialysis session was a drop in cardiac output, in stroke volume, in mean arterial pressure, and in central blood volume, whereas heart rate increased. Total peripheral resistance did not change significantly. Overall, this pattern remained stable over time in both groups and was uninfluenced by ARB treatment. The total number of intradialytic hypotensive episodes was (placebo/ARB) 50/63 (P = 0.4). Ultrafiltration volume, left ventricular mass index, plasma albumin, and change in intradialytic total peripheral resistance were significantly associated with intradialytic hypotension in a multivariate logistic regression analysis based on baseline parameters. Use of the ARB irbesartan as an add-on to other antihypertensive therapy did not significantly affect intradialytic hemodynamics, neither in short nor long-term, and no significant increase in hypotensive episodes was seen. Clinicaltrials.gov NCT00791830
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影响因子：
19.6
作者：
Karamperis, N;Sloth, E;Jensen, JD
通讯作者：
Jensen, JD
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13.2
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Daugirdas, JT
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6.1
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Barth, C;Boer, W;Passlick-Deetjen, J
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Passlick-Deetjen, J
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13.2
作者：
Karamperis, N;Sloth, E;Jensen, JD
通讯作者：
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