PREVENTION OF LEFT VENTRICULAR HYPERTROPHY AND RENAL FAILURE IN PKD

本研究将确定哪种血压水平能最好地逆转高血压患者的左心室肥厚、肾功能衰竭和改善尿钠。ADPKD的肾囊性受累与高血压、左心室肥厚（LVH）和慢性肾衰竭的高发有关。积极控制血压可使LVH消退，逆转慢性肾功能衰竭的进展。具体而言，目的是确定将血压控制在平均动脉压(MAP) <=92 mm Hg是否比将血压维持在正常的公认上限（MAP为100 - 107 mm Hg）更有效地减缓LVH和逆转ADPKD慢性肾功能衰竭的进展。该方案将为高血压ADPKD患者抗高血压治疗的长期效果和血压控制水平提供重要信息，以延缓肾功能丧失和LVH消退。该研究的患者数量和长期性质将为临床医生管理高血压ADPKD患者提供重要指导，并提供有关这些患者肾脏预后不良的危险因素的信息。

This study will determine which level of blood pressure best reverses left ventricular hypertropny, renal failure and improves natriuresis in hypertensive patients. The cystic involvement of the kidney in ADPKD is associated with a high incidence of hypertension, left ventricular hypertrophy (LVH) and progression of chronic renal failure. Aggressive control of blood pressure will regress LVH and reverse the progression of chronic renal failure. Specifically the aim is to determine if control of blood pressure to a mean arterial pressure (MAP) of <=92 mm Hg will be more effective in slowing LVH and reversing the progression of chronic renal failure in ADPKD than will blood pressures maintained at the accepted upper limits of normal (MAP of 100 - 107 mm Hg). This protocol will provide important information regarding the long-term effects of antihypertensive therapy and level of blood pressure control in hypertensive ADPKD patients with regard to retardation of loss of renal function and regression of LVH. The number of patients and the long-term nature of this study will provide important guidelines to clinicians managing hypertensive ADPKD patients as well as provide information regarding risk factors for poor renal outcome in these patients.