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Dadun > Depósito Académico > CIMA (Centro de Investigación Médica Aplicada) > Área de Ciencias Cardiovasculares > Cardiopatía hipertensiva > DA - CIMA - Cardiovasculares - Cardiopatía hipertensiva - Artículos de Revista >

Effect of antihypertensive treatment on progression of renal insufficiency in non-diabetics patients. (Espiral trial)
Authors: Marin, R. (Rafael)
Ruilope, L.M. (Luis M.)
Aljama, P. (P.)
Aranda, P. (P.)
Diez, J. (Javier)
Keywords: Progression of renal insufficiency
ACE inhibition
Calcium antagonist
Non-diabetic chronic renal failure
Arterial hypertension
Issue Date: 1995
Publisher: Sociedad Española de Nefrología
Publisher version: http://bit.ly/KhRLri
ISSN: 1989-2284
Citation: Marin R, Ruilope LM, Aljama P, Aranda P, Diez J. Effect of antihypertensive treatment on progression of renal insufficiency in non-diabetics patients. (Espiral trial). Nefrologia 1995;15(5):464-475.
Abstract
A three year randomized, multicenter, prospective, open trial, will be developed with the aim of studying the influence of antihypertensive therapy on chronic renal failure progression in non-diabetics patients. The study will compare the effects of an angiotensin converting enzyme inhibitor, fosinopril, with a slow release calcium antagonist, nifedipine slow release. Two hundred and fifty patients, with progressively fallug renal function, shom by an increase of serum creatinine (SCr) of at least 25 % in the 2 years preceding entry to the study, and SCr levels between 1.5 and 4.0 mg/dl, will be included. The primary end point of the trial will be the rate of change of SCr (mg/dl/month) and of the reciprocal of serum creatinine concentration (1/SCr) over time. The secondary end point will be the percentage of patients with a doubling of SCr, progreswith to dialytic therapy, or deah during the study. Patients with nephrotic syndrome (serum albumin concentration < 3 g %), systemic disease (including diabetes), severe cardiac or hepatic dysfunction, malignant or renovascular hypertension, obstructive nephropathy, initial serum potassium concentration > 5.8 mmol/l and initial serum total cholesterol level ³ 270 mg/dl, will be excluded. After a «wash out» period of four weeks, patients with arterial blood pressure ³ 140/90 will be assigned either to fosinopril (10-30 mg/day) or nifedipine slow release (30-60 mg/day). In case of insufficient blood pressure control, furosemide (20- 100 mg/d) will be added as a first step and then atenolol (25-100 mg/d) and/or doxazosine (1-12 mg/d) in order to maintain arterial blood pressure control under 140/90. All patients will receive a diet with 4-5 g/day salt content and a protein content of 0.8-1 g/kg body weight. At the begining of the study, at 2, 4 and 8 weeks, and every 4 months, the following parameters will be measured: supine blood pressure after 5 minutes rest, body weight, SCr, 1/SCr, serum albumin, electrolytes and lipid pattern; urinary protein and urea concentrations and creatinine clearange. The relation between the progression chronic renal failure and ambulatory blood presure during 24 hours will be studied in some patients.
Permanent link: http://hdl.handle.net/10171/21957
Appears in Collections:DA - CIMA - Cardiovasculares - Cardiopatía hipertensiva - Artículos de Revista

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