A Set Of Remarkable Points Regarding STI571

The CCB verapamil had no effect on kidney morphology in wild-type rats while ADPKD rats showed greater kidney weight and cyst index and increased cell proliferation and apoptosis, with consequent exacerbation of renal cystic disease [60]. In humans, dihydropyridine CCBs have UNC2881 been compared with RAAS inhibitors (ACE inhibitors and ARBs), and patients receiving CCB treatment appeared to have a poorer renal function outcome [61]. Because of these findings, both dihydropyridine and non-dihydropyridine CCBs should probably be avoided as first- and probably second-line treatment in patients with ADPKD. However, considering that ADPKD patients often show resistant hypertension and CCBs are good antihypertensive drugs, they should certainly be third-line treatment. Diuretics Because aldosterone levels are greater in hypertensive ADPKD patients than in essential hypertensives, and higher aldosterone levels may lead to sodium retention, diuretics should be considered as second-line treatment in hypertensive ADPKD. It must be noted, however, that diuretic treatment may lead to an extra activation of the RAAS owing to volume depletion. In hypertensive ADPKD patients with normal renal function, thiazide diuretics are the first choice. In those with impaired renal function and glomerular filtration click here rate find more direct vasodilators) have not been compared with RAAS inhibitors and may play a secondary role in hypertension treatment in this population. Blood pressure goal Another important point to be considered is the BP goal. The Modified Diet in Renal Disease study, which included 200 participants with ADPKD, compared two levels of BP control in patients with a glomerular filtration rate between 13 and 55 mL/min/1.73 m2. No benefits were found in the lower BP control (mean BP 60 mL/min/1.73 m2). In summary, until more evidence is available, hypertensive ADPKD patients should have a BP of