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Studies on protection of progression of renal impairment.

保护肾功能损害进展的研究。

基本信息

批准号：
03454221
负责人：
SARUTA Takao
金额：
$ 3.2万
依托单位：
Keio University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1991
资助国家：
日本
起止时间：
1991 至 1993
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03454221/
关键词：
hypertension renal impairment salt protein Calcium Ca channel blocker ACE inhibitor 降圧薬腎不全

项目摘要

Diet and blood pressure are important in the control of renal function in various renal diseases. Until now it has been made clear that appropriate restriction of salt and protein is effective in patients with renal impairment, but it is unknown that calcium(Ca) supplementation is useful for those patients. Furhtermore it is still controversial how much hypertension is harmful in pateints with renal impairment. In this study the effects of diet and antihypertensive drugs on renal function and blood pressure were studied in animal experiments and in patients with renal impairment.In the first animal experiment using DOCA-salt adriamycin treated rats, oral Ca supplementation ameliolated a part of chronic progression of renal damage by phosphate binding action. In the second animal experiment using 5/6 nephrectomized salt loaded spontaneously hypertensive rats, effects of various antihypertensive drugs on renal function and hypertension were studied. In this study it was demonstrated that … More an angiotensin converting enzyme(ACE) inhibitor and a Ca channel blocker are more effective than a diuretic to the progression of renal impairment and renal histological changes. However, there were no significact differences between the ACE inhibitor and the Ca channel blocker, although the Ca channel blocker didn't dilate the efferent arteriole different from the ACE inhibitor.In hypertensive patients with renal impairment 2 types of Ca channel blockers were demonstrated to be effective in the control of hypertension and renal function Ca channel blockers seemed to be safer than ACE inhibitors in patients with advance renal damage showing serum creatinine over 2 mg/dl.From these studies it was suggested that Ca supplementation in addition to salt and protein restriction is effective for prevention of renal impairment, and Ca channel blockers are also effective in the control of hypertension and renal function as well as ACE inhibitors, although the mechanims of action of Ca channel blockers were supposed to be different from that of ACE inhibitors. Less

饮食和血压在控制各种肾脏疾病的肾功能方面很重要。到目前为止，已经清楚的是，适当限制盐和蛋白质对肾损害患者有效，但尚不清楚钙（Ca）补充剂对这些患者是否有用。此外，高血压对肾损害的危害程度仍有争议。本研究在动物实验和肾损害患者中研究了饮食和降压药物对肾功能和血压的影响。在第一次使用DOCA盐阿霉素治疗大鼠的动物实验中，口服钙补充剂通过磷酸盐结合作用改善了部分慢性进展的肾损伤。在第二个动物实验中，使用5/6肾切除的盐负荷自发性高血压大鼠，研究了各种降压药物对肾功能和高血压的影响。这项研究表明， ...更多信息血管紧张素转换酶（ACE）抑制剂和钙通道阻滞剂比利尿剂更有效地抑制肾损伤和肾组织学变化的进展。而ACE抑制剂与Ca通道阻滞剂之间无显著性差异，在高血压合并肾损害患者中，两种钙通道阻滞剂均能有效地控制高血压和肾功能，在晚期肾损害患者中，钙通道阻滞剂似乎比ACE抑制剂更安全。这些研究表明，除了盐和蛋白质限制之外，补充钙对于预防肾损害是有效的，并且钙通道阻断剂在控制高血压和肾功能方面也是有效的，以及ACE抑制剂，尽管钙通道阻断剂的作用机制应该与ACE抑制剂不同。少