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Related Experiment Videos

Renal function in long-term minoxidil-treated patients.

H C Mitchell, W A Pettinger

    Journal of Cardiovascular Pharmacology
    |January 1, 1980
    PubMed
    Summary
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    Minoxidil treatment for refractory hypertension can lead to worsening kidney function in some patients, indicated by increased serum creatinine. Elevated norepinephrine levels may play a role in this renal disease progression.

    Area of Science:

    • Nephrology
    • Cardiology
    • Pharmacology

    Background:

    • Refractory hypertension poses significant challenges in patient management.
    • Minoxidil, in combination with sympathetic suppressants and diuretics, is used for severe hypertension.
    • The long-term effects of this regimen on renal function require further investigation.

    Purpose of the Study:

    • To assess the impact of long-term minoxidil, sympathetic suppressants, and diuretics on renal function in hypertensive patients.
    • To investigate the relationship between neuroendocrine factors and renal disease progression in this patient cohort.

    Main Methods:

    • Longitudinal monitoring of renal function (serum creatinine) in 20 patients over 2-7 years.
    • Measurement of plasma norepinephrine and plasma renin activity.

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  • Correlation analysis between renal function, blood pressure control, therapy duration, and neuroendocrine markers.

    • Main Results:

    • Nine of 20 patients experienced a significant increase in serum creatinine (>1 mg/dl), with 4 progressing to hemodialysis.
    • Eleven patients showed no significant renal function decline; 3 with prior malignant hypertension and renal failure experienced reversal.
    • Higher plasma norepinephrine and lower plasma renin activity were observed in patients with renal disease progression.
    • Serum creatinine correlated with plasma norepinephrine levels.

    Conclusions:

    • Long-term minoxidil-based therapy can be associated with progressive renal disease in a subset of refractory hypertensive patients.
    • Elevated plasma norepinephrine, potentially due to increased release rather than impaired renal clearance, may be linked to renal deterioration.
    • Further research is needed to elucidate the causal relationship between elevated norepinephrine and renal disease progression in hypertension.