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Antiadrenergic antihypertensive drugs: their effect on renal function
Annual Review of Pharmacology and Toxicology
|January 1, 1984
Summary
Peripheral alpha antagonists preserve kidney function and blood flow during low blood pressure. Beta blockers have varied effects, with some potentially reducing renal blood flow (RBF) and glomerular filtration rate (GFR).
Area of Science:
- Pharmacology
- Nephrology
- Cardiovascular Medicine
Background:
- Peripheral alpha antagonists improve renal hemodynamics and autoregulation during reduced systemic perfusion.
- Central alpha agonists exhibit variable effects on renal blood flow (RBF) and glomerular filtration rate (GFR).
Purpose of the Study:
- To review the effects of alpha-adrenergic antagonists and agonists on renal function.
- To examine the impact of various beta blockers on renal hemodynamics and autoregulation.
Main Methods:
- Review of existing literature on alpha-adrenergic antagonists and agonists.
- Analysis of studies investigating beta blockers' effects on renal blood flow and autoregulation.
Main Results:
- Peripheral alpha antagonists preserve renal hemodynamics and autoregulation.
- Central alpha agonists (clonidine, guanabenz, alpha-methyl dopa) show mixed effects on RBF and GFR.
- Beta blockers, particularly propranolol, can reduce RBF and GFR, potentially due to impaired autoregulation; others like nadolol and metoprolol may preserve RBF.
Conclusions:
- Peripheral alpha antagonists are beneficial for renal function under reduced perfusion.
- The effects of central alpha agonists on renal function are inconsistent.
- Beta blockers have variable renal effects, with propranolol posing a potential risk for reduced RBF and GFR, though clinical significance remains unclear.