Safety And Efficacy Of Losartan (50 Mg) In Post Dialysis Euvolemic Hypertensive Patients: A Single-Blind Randomized Control Trial
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Date
2018-01
Authors
Aftab, Raja Ahsan
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Patients with End Stage Renal Disease (ESRD) require lifelong fluid replacement therapy or renal transplant. Almost 60-90 % haemodialysis patients are hypertensive. Studies aimed at elucidating the pathophysiology of hypertension among haemodialysis patients concluded that 90% cases resulted from sodium and volume overload (volume-dependent), while the majority of the remaining cases have elevated renin activity (renin dependent), leading to renin dependent high blood pressure. Since there is a constant volume variation during dialysis session, there is a strong possibility for activation of Renin Angiotensin Aldosterone System (RAAS) during dialysis that causes high blood pressure even if they are post dialysis euvolemic. Keeping in view the importance of RAAS system, current study was designed to assess the safety and effectiveness of losartan 50 mg (losartan dose recommended by K/DOQI Clinical Practice Guidelines) in reducing blood pressure among post-dialysis euvolemic hypertensive patients and observing their survival trends. A single centre, prospective, randomised, single-blind trial was conducted to assess the effect of losartan 50mg every other day (EOD), once a morning (OM) among post-dialysis euvolemic hypertensive patients. Post-dialysis euvolemic assessment was done by a Body Composition Monitor (BCM). Covariate Adaptive Randomization was used for allocation of participants to the standard or intervention arm, and these participants were followed up for twelve months. Pre-, intra- and post-dialysis session blood-pressure (BP) measurements were recorded, and any
adverse events were confirmed using Naranjo scale.
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Keywords
Safety and efficacy of losartan (50 mg) in post , dialysis euvolemic hypertensive patients