Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism
スポンサーリンク
概要
- 論文の詳細を見る
Objective The Jikei Optimal Antihypertensive Treatment (JOINT) study originally evaluated the effect of a fixed-dose formulation of losartan (LOS) (50 mg) plus 12.5 hydrochrolthiazide (HCTZ) for achieving better blood pressure (BP) control in patients with uncontrolled hypertension. This study is a sub-analysis of the JOINT study, focusing on the effect of LOS/HCTZ on the uric acid (UA) metabolism. Methods Among 228 participants in the JOINT study, a total of 164 patients whose blood and urinary UA specimens were available were included in the present analyses. Results Six months after switching from the prior antihypertensive agent(s) to a single tablet formulation of LOS/HCTZ, the overall serum UA concentration (sUA) increased from 6.0 ± 1.6 mg/dL to 6.2 ± 1.6 mg/dL (p=0.029). The urinary UA/creatinine (Cr) ratio increased from 0.45 +/- 0.21 to 0.50 +/- 0.25 (p=0.014), and the fractional excretion of UA (FEUA) also increased, from 7.1 +/- 3.6 to 7.0 +/- 4.3, p=0.04). Multivariate regression analyses of the basal parameters showed the change in sUA (ΔUA) to correlate with the basal sUA (β=-0.483, p<0.001), estimated glomerular filtration rate (eGFR) (β=-0.202, p=0.007) and systolic BP (β=0.147, p=0.038). In addition, the ΔUA also correlated with the changes in the estimated glomerular filtration rate (ΔeGFR) (β=-0.332, p<0.001). When the patients were classified into two groups depending on their basal sUA, those with a basal sUA ≥7 mg/dL exhibited a decrease in their sUA, whereas the rest of those with a sUA <7 mg/dL experienced an increase. Furthermore, patients who had previously been treated with LOS alone had a greater increase in the sUA than those treated with an angiotensin II blocker (ARB) other than LOS alone. Conclusion Antihypertensive therapy with a single tablet formulation of LOS/HCTZ is considered to be a useful option for controlling both BP and sUA, especially in uncontrolled hypertensive patients with hyperuricemia.
著者
-
Kuriyama Satoru
Division Of Nephrology Saiseikai Central Hospital
-
Hosoya Tatsuo
Division Of Kidney And Hypertension Department Of Internal Medicine Jikei University School Of Medic
-
Ohno Iwao
Division Of Kidney And Hypertension Department Of Internal Medicine Jikei University School Of Medic
-
Otsuka Yasushi
Division Of Medical Zoology Oita Medical University
-
Yoshizawa Takeo
Division Of Nephrology Saiseikai Central Hospital Jikei University School Of Medicine
-
KOBAYASHI Akimitsu
Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine
-
Hosoya Tatsuo
Division of Kidney and Hypertension, Jikei University School of Medicine, Japan
-
Kuriyama Satoru
Division of Kidney and Hypertension, Jikei University School of Medicine, Japan
-
Otsuka Yasushi
Division of Kidney and Hypertension, Jikei University School of Medicine, Japan
-
Kobayashi Akimitsu
Division of Kidney and Hypertension, Jikei University School of Medicine, Japan
関連論文
- Morning Blood Pressure Predicts Hypertensive Organ Damage in Patients with Renal Diseases : Effect of Intensive Antihypertensive Therapy in Patients with Diabetic Nephropathy
- Possible Involvement of Endothelin-1 in Cardioprotective Effects of Benidipine
- Antiproteinuric Effects of Combined Antihypertensive Therapies in Patients with Overt Type 2 Diabetic Nephropathy
- Association of Angiotensinogen Gene Polymorphism with Erythropoietin-Induced Hypertension : a Preliminary Report
- Circulating Adrenomedullin in Erythropoietin-Induced Hypertension
- Partial Deficiency of Hypoxanthine-Guanine Phosphoribosyltransferase Manifesting as Acute Renal Damage
- Characteristics of the clinical practice patterns of hemodialysis in Japan in consideration of DOPPS and the NKF/DOQI guidelines
- Reduction of peritoneal membrane permeability by long-term use of neutral-pH peritoneal dialysis solution : a preliminary report in high transporters
- Morning blood pressure at home predicts erythropoietin-induced hypertension in patients with chronic renal diseases
- Pseudoaldosteronism due to the concurrent use of two herbal medicines containing glycyrrhizin : interaction of glycyrrhizin with angiotensin-converting enzyme inhibitor
- Cellular Physiology of Rat Cardiac Myocytes in Cardiac Fibrosis : In Vitro Simulation Using the Cardiac Myocyte/Cardiac Non-Myocyte Co-Culture System
- Isolated Adrenocorticotropin Deficiency Presenting with Impaired Renin-Angiotensin-Aldosterone System and Suppressed Parathyroid Hormone-Vitamin D Axis
- Anti-GBM glomerulonephritis in mice lacking IL-1β-converting enzyme (ICE)
- evidence-based practice guideline for the treatment of chronic kidney disease
- In vitro and Pathological Investigations of MODY5 with the R276X-HNF1β(TCF2) Mutation
- Restoration of peritoneal integrity after withdrawal of peritoneal dialysis : characteristic features of the patients at risk of encapsulating peritoneal sclerosis
- A case of renal sarcoidosis : a special reference to calcium metabolism as a diagnostic and the therapeutic implications
- Successful effect of triple blockade of renin-angiotensin-aldosterone system on massive proteinuria in a patient with chronic kidney disease
- Lung metastatic calcification in long-term dialysis patients, detected by single photon emission computed tomography (SPECT)
- Safety of long-term tacrolimus therapy for rheumatoid arthritis : an open-label, uncontrolled study in non-elderly patients
- Frequency of Gouty Arthritis in Patients with End-stage Renal Disease in Japan
- Correction of CAPD catheter displacement using alpha-replacement method
- Blockade of angiotensin II type-1 receptor increases salt sensitivity in Sprague-Dawley rats
- Preclinical Cushing's Syndrome Associated with Non-Islet Cell Tumor Hypoglycemia ; An Additional Report
- Rapidly progressive cryoglobulinemic glomerulonephritis
- Effect of Fenofibrate on Uric Acid Metabolism and Urate Transporter 1
- Sevelamer Decreases Serum Uric Acid Concentration through Adsorption of Uric Acid in Maintenance Hemodialysis Patients
- Genetic variation in the expression of the six hsp genes in the presence of heat shock in Drosophila melanogaster
- Augmented antihypertensive effect of a fixed combination formula of candesartan and hydrochlorothiazide combined with furosemide in a patient on peritoneal dialysis
- A case of slowly progressive scleroderma kidney
- Relationship between Hyperuricemia and Body Fat Distribution
- The target hemoglobin in non-dialysis CKD : still a matter for debate?
- Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism
- Characteristics of spontaneous calcium oscillations in renal tubular epithelial cells
- Diffuse tubulointerstitial nephritis associated with ANCA-negative pauci-immune glomerulonephritis
- A case of idiopathic membranoproliferative glomerulonephritis with a transient glomerular deposition of nephritis-associated plasmin receptor antigen
- Diffuse Tubulointerstitial Nephritis Accompanied by Renal Crystal Formation in an HIV-infected Patient Undergoing Highly Active Antiretroviral Therapy
- Home systolic blood pressure on the morning of dialysis days has prognostic impact for hypertensive hemodialysis patients
- Hypereosinophilia Associated with Increased Serum Levels of Carcinoembryonic Antigen
- A lower level of reduced albumin induces serious cardiovascular incidence among peritoneal dialysis patients
- Medullary ray injury in renal allografts
- Obesity-Related Nephropathy Associated with a History of IgA Nephropathy
- Guidelines on the Use of Iodinated Contrast Media in Patients With Kidney Disease 2012 : Digest Version
- Clinical features and long-term renal outcomes of Japanese patients with obesity-related glomerulopathy
- The predictive value of attenuated proteinuria at 1 year after steroid therapy for renal survival in patients with IgA nephropathy