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[Hypotensive and diuretic effect of heparin in patients with glomerulonephritis]
Insights
Heparin demonstrated hypotensive and diuretic effects in chronic glomerulonephritis patients. While beneficial for blood pressure and fluid balance, it may worsen renal function in severe cases.
Area of Science:
- Nephrology
- Pharmacology
Context:
- Chronic glomerulonephritis (CGN) presents diverse clinical and morphological variations.
- Management of CGN often involves addressing hypertension and fluid retention.
Purpose:
- To evaluate the hypotensive and diuretic properties of heparin in patients with CGN.
- To investigate the impact of heparin on blood pressure, renal function, and electrolyte excretion in CGN.
Summary:
- Heparin administration led to a decrease in arterial blood pressure in all 95 CGN patients, with maximal effects observed between days 35-50.
- Diuretic and natriuretic effects were noted in 81 patients, peaking around days 14-16 with maximal heparin doses.
- Heparin's actions are attributed to the inhibition of aldosterone synthesis, impacting diuresis, natriuresis, and blood pressure.
- In patients with renal failure (GFR < 35 ml/min), heparin-induced blood pressure reduction was associated with renal function deterioration.
Impact:
- Heparin's hypotensive and diuretic properties offer potential therapeutic applications in nephrological patient care.
- Understanding heparin's dual effect on blood pressure and renal function is crucial for patient selection and monitoring.
Abstract:
The hypotensive and diuretic properties of heparin were evaluated in 95 patients with different clinical and morphological varieties of chronic glomerulonephritis (CGN). The arterial blood pressure dropped in all the patients treated with heparin. The maximal effect was attained toward the end of heparin treatment (by the 35th-50th day). In patients with hypertonic and mixed nephritis associated with renal failure, (the glomerular filtration rate under 35 ml/min), the BP lowering induced by heparin was accompanied by the deterioration of renal function. The diuretic and natriuretic effects were recorded in 81 out of the 95 patients. The maximal values of diuresis and sodium excretion were detected on the 14th-16th day of the treatment during the use of the maximal doses of heparin. It was established that heparin-induced inhibition of aldosterone synthesis plays the key role in the genesis of the diuretic, natriuretic and hypotensive action of the drug. It is concluded that diuretic and hypotensive properties of heparin can be made use of in the treatment of nephrological patients.