Pyrazinoylguanidine in end-stage renal disease: a prospective, placebo-controlled pilot study.
Cardiovascular disease is the leading cause of mortality in end-stage renal disease (ESRD) patients receiving dialysis. In these patients, hypertriglyceridemia appears to increase the risk of accelerated atherosclerosis. The present placebo-controlled study evaluated prospectively lipid-lowering effects of pyrazinoylguanidine (PZG) in 6 ESRD patients undergoing maintenance hemodialysis. The design of the study entailed a placebo phase of 1 week followed by 3 weeks of PZG, 400 mg three times a day. Compared to placebo, PZG reduced serum triglycerides (PZG vs. placebo 370 +/- 171 vs. 414 +/- 182 mg/dl; p = 0.01). PZG also tended to decrease total cholesterol. In addition, PZG selectively lowered blood glucose in hyperglycemic patients. PZG was well tolerated; it did not interfere with hemodynamic parameters or alter liver function tests, nutritional parameters or dialysis clearance.
Department of Medicine, The Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
N
N
Ahsan
Z
Z
Korsunsky
K H
KH
Beyer
E S
ES
Vesell
D000284:Administration, Oral; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D005260:Female; D006146:Guanidines / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D015228:Hypertriglyceridemia / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011719:Pyrazines / Q000008:administration & dosage / Q000627:therapeutic use*; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D006146:Guanidines; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D011719:Pyrazines; D014280:Triglycerides; C056104:2-pyrazinoylguanidine; D002784:Cholesterol