[Drugs used in the treatment of arterial hypertension in dialysis patients in the Piedmont. What correlations between personal and clinical data can be made from the registry data?].
The therapeutical approach to arterial hypertension in the general population is now relatively well classified, whereas it remains a controversial problem in dialytic patients. The aim of this study was to evaluate the antihypertensive drugs used in dialytic patients in Piedmont and to identify correlations with other personal and clinical data. The authors analysed the data in the Piedmont Dialysis and Transplant Register concerning new patients admitted to dialysis during the period 1990-1995 (2,664 patients at 31/12/1995) and 1,373 patients who began dialysis during the period 1990-1993. A study of the antihypertensive drugs using in single and combined therapy over the five-year period shows major variations in the 45-65 year-old age bracket (increased ACE-inhibitors in single therapy, 15.5-25.6%, increased vasodilators in combined therapy, 15.3-21%). In patients aged > or = 65 years old a slight increase was found in the use of beta-blockers in monotherapy. Antihypertensive drugs at the 1st control (1990-1995 entries) appeared to be stable over the five-year period. From the 1,373 patients who started dialysis in the period 1990-1993, with at least three subsequent controls, the authors selected those hypertensive or normotensive patients receiving ACE-inhibitor therapy (best survival in general population) and compared their survival with that of patients receiving alternative antihypertensive treatment. No significant differences were found. The stability of the antihypertensive drugs taken by these patients over the past 5 years backs the hypothesis of a greater attention paid by nephrologists to the introduction of new drugs, both because of the frequent onset of collateral effects and owing to the special pharmacokinetics present in dialytic patients.
Stramignoni
E
E
Servizio di Nefrologia e Dialisi, Ospedale degli Infermi, Biella.
Bergia
R
R
Dionisio
P
P
Valenti
M
M
Berto
I M
IM
Cravero
R
R
Agostini
B
B
Caramello
E
E
Piccoli
G B
GB
Bajardi
P
P
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D006435:Renal Dialysis; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D014665:Vasodilator Agents
I farmaci utilizzati per il trattamento della ipertensione arteriosa nei pazienti in dialisi in Piemonte. Quali correlazioni con i dati anagrafici e clinici sono possibili dai dati del registro?