Atenolol Beats Lisinopril for HTN in Dialysis (CME/CE)

ATLANTA (MedPage Today) -- For dialysis patients with hypertension and left ventricular hypertrophy, atenolol may provide better blood pressure control than lisinopril, with fewer cardiovascular risks, researchers reported here.
Source: MedPage Today Cardiovascular - Category: Cardiology Source Type: news

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Purpose of review Chronic kidney disease (CKD) is a pervasive and growing health concern that has a significant impact on mortality and morbidity, putting stress on global healthcare systems. CKD affects ∼14% of general populations and ∼36% of high-risk populations and is projected to rise in the coming decade due to increasing rates of diabetes and hypertension. Recent findings Screen, triage, and treat programs aim to detect early stage disease with the intention of promoting medical and lifestyle interventions in line with a patient's level of risk that may slow disease progression and reduce morbidity and ...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research
Purpose of review We will examine the current and future options in management of anemia in dialysis patients focusing on recent trials in iron supplementation and alternatives to erythropoietin-stimulating agents (ESAs). Recent findings We review the literature on Erythropoietin (EPO)-stimulating agents, focusing on the risk benefits of various options available. We review the recent practice changing trial in iron supplementation in dialysis patients with chronic kidney disease and movements in the research on alternatives to EPO-stimulating agents primarily hypoxia-inducible factor prolyl hydroxylase inhibitors (HI...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research
A 43 ‐year‐old man who was treated with interferon‐beta for multiple sclerosis was presented with hypertension, headache, nausea/vomiting, blurred vision, and renal dysfunction. The treatment with drugs and dialysis relieved the symptoms. Despite plasmapheresis is known to cause improvement in rena l function, no such improvement was seen in patient. AbstractA 43 ‐year‐old man who was treated with interferon‐beta for multiple sclerosis was presented with hypertension, headache, nausea/vomiting, blurred vision, and renal dysfunction. The treatment with drugs and dialysis relieved the symptoms. Despite plasmapher...
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infect...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
CONCLUSION: Our first-line therapy of hypertension in hemodialysis is the assessment and management of dry-weight and optimization of dialysis prescription. Based on the available clinical-trial evidence, we prescribe atenolol 3 times/week after dialysis as first-line pharmacological option of hypertension to our patients without specific indications for other agents. Long-acting dihydropyridines and ACEIs/ARBs are our second-line and third-line choices, respectively. We avoid using MRAs and await results from ongoing trials testing their safety and efficacy. In patients receiving maintenance hemodialysis, randomized trial...
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research
In this study, we aimed to perform interdialytic ambulatory blood pressure monitoring (ABPM) in patients with IDHN to find whether high BP persists at home. METHODS: In this case-control study, ABPM was performed during a 44-hours interdialytic period in patients on maintenance hemodialysis (HD) with pre-dialysis systolic BP (SBP) above 130 mmHg. Bland- Altman graphs were used to investigate the magnitude of the difference between the results of ABPM records and intradialytic BP measurements in patients with and without IDHN. RESULTS: A total of 56 patients were enrolled in our study (29 in the IDHN group and 27 in...
Source: Iranian Journal of Kidney Diseases - Category: Urology & Nephrology Tags: Iran J Kidney Dis Source Type: research
Authors: Galliani M, Vitaliano E, Chicca S, Calvaruso L, Di Lullo L, Iorio F, Tosti ME, Paone A Abstract The clinical manifestations of ADPKD are related to the growth of renal cysts. Renal volume has been recognised as the biomarker that is able to identify those patients at risk of complications (hypertension and haematuria) and at risk of progression to End Stage Renal Disease (ESRD). Recently, several scores have been introduced to predict the evolution of ADPKD. The Mayo Clinic Group developed a classification based on renal volume as measured by CT or MRI and corrected for age and height (Ht-TKV); this allowe...
Source: International Journal of Nephrology - Category: Urology & Nephrology Tags: Int J Nephrol Source Type: research
We report a case of a 66-year-old man on maintenance dialysis who developed acute dyspnea and blood-tinged sputum after scuba diving. Vital signs on admission were significant for elevated blood pressure at 209/63 mmHg and hypoxia with an oxygen requirement of 6 L/min. Physical examination was remarkable for bilateral coarse crackles and systolic ejection murmur. Chest radiography revealed bilateral pulmonary edema. Echocardiography showed aortic stenosis and diffuse hypokinesis of left ventricular wall motion. We started bilevel positive airway pressure and administered nitroglycerin and nicardipine to maintain adequ...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research
Abstract Background: To analyze long-term outcomes and possible influencing factors in patients with endstage renal disease (ESRD) and critical limb ischemia (CLI) after major amputation compared to patients with normal renal function and non-dialysis-dependent chronic kidney disease. Patients and methods: Abstraction of single-center medical records of patients undergoing above knee (AKA) and below knee (BKA) amputation over a 10 years period (n = 436; 2009-2018). Excluded were amputations due to trauma or tumor. Patients were subdivided according to renal function in three categories: ESRD patien...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - Category: Surgery Authors: Tags: Vasa Source Type: research
Conclusion: Incidence of intradialytic hypertension is high (21.9%) with increased morbidity in terms of hospitalization and increased mortality over a period of one year.
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
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