PREVENTION OF LEFT VENTRICULAR HYPERTROPHY AND RENAL FAILURE IN PKD

这项研究将确定哪种血压水平最能逆转高血压患者的左心室肥厚、肾功能衰竭和改善尿钠排泄。 ADPKD患者肾脏囊性受累与高血压、左心室肥大（LVH）和慢性肾衰竭进展的高发病率相关。 积极控制血压将使LVH消退并逆转慢性肾衰竭的进展。 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可接受的正常上限（MAP 100 - 107 mm Hg）更有效地减缓ADPKD的LVH和逆转慢性肾衰竭的进展。 本方案将提供关于高血压ADPKD患者降压治疗的长期效应和血压控制水平的重要信息，包括肾功能丧失延迟和LVH消退。 本研究的患者数量和长期性质将为临床医生管理高血压ADPKD患者提供重要指南，并提供有关这些患者肾脏结局不良风险因素的信息。

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.