RESUMO
La conservación de la Función Renal Residual (FRR) tras el inicio de la diálisis peritoneal (DP) es esencial, tanto para la supervivencia del paciente como para la de la técnica. Los métodos de nefroprotección de eficacia probada en la insuficiencia renal crónica podrían mantener su eficaciatras el inicio de la diálisis. Este estudio demuestra que elcandesartán a dosis entre 16 y 32 mg/día es bien tolerado en pacientes normotensos en DP, y que reduce la progresión de la insuficiencia renal desde 8 mL/min/año en el período prediálisis hasta 2 mL/min/año tras iniciar la DP. La proteinuria también se reduce a la mitad al final del primer año, sin que se aprecien efectos perjudiciales sobre el control de la anemia. Concluimos que el bloqueo del receptor de angiotensina debe mantenerse tras el inicio de la DP, con independencia del control tensional, a fin de reducir el deterioro de la FRR en estos pacientes (AU)
Preservation of residual renal function (RRF) after the start of peritoneal dialysis (PD) is essential for both patient and technique survival. Nephroprotection methods of proven efficacy in chronicrenal failure may maintain their efficacy after the start of dialysis. This study shows that candesartan, at doses ranging from 16and 32 mg/day, is well tolerated in normotensive patients on PD and reduces progression of renal failure from 8 mL/min/year in the pre-dialysis period to 2 mL/min/year after PD start. Proteinuriais also decreased to a half at the end of the first year, with no harmful effects seen on anemia control. It is concluded that angiotensin receptor blockade should be maintained after the start of PD, irrespective of blood pressure control, in order to reduce RRF impairment in these patients (AU)
Assuntos
Humanos , Peritonite/fisiopatologia , Insuficiência Renal Crônica/fisiopatologia , Diálise Peritoneal/métodos , Soluções para Diálise/farmacologia , Anti-Hipertensivos/uso terapêutico , Testes de Função Renal , Taxa de Filtração Glomerular , Fatores de Risco , Doenças Cardiovasculares/complicações , Taxa de Sobrevida , Antagonistas de Receptores de Angiotensina/uso terapêuticoRESUMO
Preservation of residual renal function (RRF) after the start of peritoneal dialysis (PD) is essential for both patient and technique survival. Nephroprotection methods of proven efficacy in chronic renal failure may maintain their efficacy after the start of dialysis. This study shows that candesartan, at doses ranging from 16 and 32 mg/day, is well tolerated in normotensive patients on PD and reduces progression of renal failure from 8 mL/min/year in the pre-dialysis period to 2 mL/min/year after PD start. Proteinuria is also decreased to a half at the end of the first year, with no harmful effects seen on anemia control. It is concluded that angiotensin receptor blockade should be maintained after the start of PD, irrespective of blood pressure control, in order to reduce RRF impairment in these patients.
