Use of Thiazides to Treat Hypertension and Advanced CKD.

PURPOSE OF REVIEW: Hypertension is often difficult to control in patients with CKD as manifested by suboptimal control rates in this population. Use of thiazides in CKD patients has been limited as these agents are thought to be ineffective in reducing blood pressure in people with advanced CKD. This review summarizes recent studies impacting indications and safety of use of thiazide in patients with CKD and discusses the mechanism of how thiazides reduce blood pressure. RECENT FINDINGS: Chlorthalidone reduces blood pressure compared to placebo in patients with advanced CKD, challenging the belief that thiazide diuretics lose efficacy at lower levels of GFR. Recent clinical trial data indicate that thiazides are effective in patients with advanced kidney disease for blood pressure lowering. However, monitoring of electrolytes and kidney function is important to ensure patient safety when prescribing these agents in patients with CKD.

Effects of dietary supplementation of organic chromium (picolinate) on physical and biochemical characteristics of semen and carcass traits of male turkeys.

This experiment investigated the effect of dietary chromium (Cr as picolinate) on physical and biochemical characteristics of semen and carcass traits of adult male turkey. Seventy-two (72) male turkeys (16 weeks old) were randomly distributed into four dietary treatment groups (4×3×6) for a period of 24 weeks. Three experimental diets were supplemented with 250, 500 and 750µg Cr/kg (T2, T3 and T4 respectively) in basal diet (T1 considered as control). Semen physical characteristics viz. sperm concentration, progressive motility, live and dead count of spermatozoa and fertility differed significantly (P<0.05). Sperm concentration, progressive motility and fertility were higher and dead count was lower in T4 (750µg) group than control (T1) or other dietary treatments (T2 or T3) group. Semen biochemical parameters like creatinine, acid phosphatase (ACP) and alkaline phosphatase (ALP) concentration did not differ significantly among the dietary treatment groups, whereas, total protein, glucose, malondialdehyde (MAD) and cholesterol concentration differed significantly (P<0.05) amongst the treatment groups. Protein and MAD were higher while glucose and cholesterol concentrations were lower in T3 and T4 group than control or T1 group. The shrinkage loss, eviscerated yield, relative weight (as percent of body weight) of breast, thigh and liver improved on supplementation of Cr leading to significantly higher in T4 group in comparison to control. From this study, it could be concluded that supplementation of chromium as chromium picolinate, at 750µg/kg level in diet was beneficial for improving physical characteristics of semen, carcass yield and breast yield of adult male turkeys. However, Cr levels of 500 or 750µg/kg in diet were beneficial for semen biochemical parameters of adult male turkeys.