リスノプリル投与量の増加が慢性腎病における脂質異常に与える副作用
Piero Ruggenenti1, Naobumi Mise, Roberto Pisoni
1Clinical Research Center for Rare Diseases Aldo and Cele Daccò, Mario Negri Institute, Bergamo, Italy. manuelap@marionegri.it
Circulation
|February 5, 2003
まとめ
アンジオテンシン変換酵素阻害剤の投与量を最大化することで,慢性腎臓病におけるタンパク質尿と脂質不全が安全に減少しました. この治療は,特に低アルブミン血症の患者の脂質プロフィールを改善し,腎臓に有害な影響はありません.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- ディスリピデミアは慢性腎臓病において一般的であり,リスクを高めます.
- アンジオテンシン変換酵素阻害剤は,タンパク質尿を減らすことができます.
研究 の 目的:
- 慢性腎不全におけるタンパク質尿と不脂血症に対するリシノプリルアップタイトレーションの評価.
- 許容される最大用量の安全性と有効性を評価する.
主な方法:
- 28人の非糖尿病性慢性腎不全の患者を対象とした長期的研究.
- リシノプリルのアップトリート剤は,最大許容量 (平均30mg/日) までに投与されます.
- タンパク質尿,脂質 (総コレステロール,LDL,HDLコレステロール,トリグリセリド) と腎臓の血液動力学をモニターした.
主要な成果:
- リシノプリルの最大投与量は,タンパク質尿,LDLコレステロール,トリグリセリドを著しく減少させた.
- 脂質の減少は用量依存であり,血清アルブミン値の増加と相関していた.
- 高コレステロール血症は,低アルバミネミックな患者でより改善しました.
- リジノプリルはよく耐えられ,腎臓の血液動力学に有意な影響はなかった.
結論:
- ACE阻害剤の最大許容量投与は,慢性腎疾患における不脂血症を安全に改善します.
- ハイパートリグリセリデミアは,直接的,用量依存的な効果によって改善されました.
- 高コレステロール血症は,腎臓症候群の改善によって改善され,特に低アルバミネム症候群の患者で改善されました.
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