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Lisinopril in hypertensive patients with renal function impairment
P E de Jong1, A J Apperloo, J E Heeg
1Department of Medicine, State University Hospital, Groningen, The Netherlands.
Nephron
|January 1, 1990
Summary
Lisinopril effectively lowers blood pressure in patients with kidney issues. Dosage adjustments based on initial kidney function and prolonged treatment are recommended to maintain efficacy and manage potential side effects like hyperkalemia.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Hypertension and impaired renal function present a complex clinical challenge.
- Angiotensin-converting enzyme (ACE) inhibitors are a cornerstone in managing these conditions.
Purpose of the Study:
- To evaluate the antihypertensive and renal effects of lisinopril in patients with moderate-to-severe hypertension and impaired renal function.
- To investigate the relationship between lisinopril dose, serum levels, and clinical response over time.
Main Methods:
- Prospective study involving patients with hypertension and reduced glomerular filtration rate (GFR).
- Treatment with lisinopril monotherapy for 12 weeks, followed by a 1-year follow-up.
- Monitoring of blood pressure, serum drug levels, GFR, and incidence of hyperkalemia.
Main Results:
- Most patients achieved good blood pressure control with lisinopril monotherapy.
- Initial correlations between dose, serum levels, and antihypertensive effect diminished with prolonged treatment.
- A significant proportion of patients (one third) experienced hyperkalemia.
- GFR decreased in two thirds of patients; however, it remained stable in those with higher pretreatment GFR and increased renal plasma flow.
Conclusions:
- Lisinopril is an effective antihypertensive agent for patients with impaired renal function.
- Dose optimization based on pretreatment GFR is crucial.
- Reduced dosage may be considered during long-term therapy to maintain efficacy and safety.