Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.

<h4>Unlabelled</h4>Treatment of hypertension in hemodialysis (HD) patients is characterised by lack of evidence for both the blood pressure (BP) target goal and the recommended drug class to use. Telmisartan, an Angiotensin receptor blocker (ARB) that is metabolised in the liver and not...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Matthias Huber, Till Treutler, Peter Martus, Antje Kurzidim, Reinhold Kreutz, Joachim Beige
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0263b6987ce24e419539ecf62afe9e46
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0263b6987ce24e419539ecf62afe9e46
record_format	dspace
spelling	oai:doaj.org-article:0263b6987ce24e419539ecf62afe9e462021-11-18T08:45:52ZDialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.1932-620310.1371/journal.pone.0079322https://doaj.org/article/0263b6987ce24e419539ecf62afe9e462013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24260194/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Unlabelled</h4>Treatment of hypertension in hemodialysis (HD) patients is characterised by lack of evidence for both the blood pressure (BP) target goal and the recommended drug class to use. Telmisartan, an Angiotensin receptor blocker (ARB) that is metabolised in the liver and not excreted via HD extracorporeal circuit might be particularly suitable for HD patients. We designed and conducted a randomised, placebo-controlled, double-blind and cross-over trial for treatment of dialysis-associated hypertension with telmisartan 80 mg once daily or placebo on top of standard antihypertensive treatment excluding other Renin-Angiotensin-System (RAS) blockers. In 29 patients after randomization we analysed BP after a treatment period of 8 weeks, while 13 started with telmisartan and 16 with placebo; after 8 weeks 11 continued with telmisartan and 12 with placebo after cross-over, respectively. Patients exhibited a significant reduction of systolic pre-HD BP from 141.9±21.8 before to 131.3±17.3 mmHg after the first treatment period with telmisartan or placebo. However, no average significant influence of telmisartan was observed compared to placebo. The latter may be due to a large inter-individual variability of BP responses reaching from a 40 mmHg decrease under placebo to 40 mmHg increase under telmisartan. Antihypertensive co-medication was changed for clinical reasons in 7 out of 21 patients with no significant difference between telmisartan and placebo groups. Our starting hypothesis, that telmisartan on top of standard therapy lowers systolic office BP in HD patients could not be confirmed. In conclusion, this small trial indicates that testing antihypertensive drug efficacy in HD patients is challenging due to complicated standardization of concomitant medication and other confounding factors, e.g. volume status, salt load and neurohormonal activation, that influence BP control in HD patients.<h4>Trial registration</h4>Clinicaltrialsregister.eu 2005-005021-60.Matthias HuberTill TreutlerPeter MartusAntje KurzidimReinhold KreutzJoachim BeigePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e79322 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthias Huber Till Treutler Peter Martus Antje Kurzidim Reinhold Kreutz Joachim Beige Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
description	<h4>Unlabelled</h4>Treatment of hypertension in hemodialysis (HD) patients is characterised by lack of evidence for both the blood pressure (BP) target goal and the recommended drug class to use. Telmisartan, an Angiotensin receptor blocker (ARB) that is metabolised in the liver and not excreted via HD extracorporeal circuit might be particularly suitable for HD patients. We designed and conducted a randomised, placebo-controlled, double-blind and cross-over trial for treatment of dialysis-associated hypertension with telmisartan 80 mg once daily or placebo on top of standard antihypertensive treatment excluding other Renin-Angiotensin-System (RAS) blockers. In 29 patients after randomization we analysed BP after a treatment period of 8 weeks, while 13 started with telmisartan and 16 with placebo; after 8 weeks 11 continued with telmisartan and 12 with placebo after cross-over, respectively. Patients exhibited a significant reduction of systolic pre-HD BP from 141.9±21.8 before to 131.3±17.3 mmHg after the first treatment period with telmisartan or placebo. However, no average significant influence of telmisartan was observed compared to placebo. The latter may be due to a large inter-individual variability of BP responses reaching from a 40 mmHg decrease under placebo to 40 mmHg increase under telmisartan. Antihypertensive co-medication was changed for clinical reasons in 7 out of 21 patients with no significant difference between telmisartan and placebo groups. Our starting hypothesis, that telmisartan on top of standard therapy lowers systolic office BP in HD patients could not be confirmed. In conclusion, this small trial indicates that testing antihypertensive drug efficacy in HD patients is challenging due to complicated standardization of concomitant medication and other confounding factors, e.g. volume status, salt load and neurohormonal activation, that influence BP control in HD patients.<h4>Trial registration</h4>Clinicaltrialsregister.eu 2005-005021-60.
format	article
author	Matthias Huber Till Treutler Peter Martus Antje Kurzidim Reinhold Kreutz Joachim Beige
author_facet	Matthias Huber Till Treutler Peter Martus Antje Kurzidim Reinhold Kreutz Joachim Beige
author_sort	Matthias Huber
title	Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
title_short	Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
title_full	Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
title_fullStr	Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
title_full_unstemmed	Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.
title_sort	dialysis-associated hypertension treated with telmisartan--diatel: a pilot, placebo-controlled, cross-over, randomized trial.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/0263b6987ce24e419539ecf62afe9e46
work_keys_str_mv	AT matthiashuber dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial AT tilltreutler dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial AT petermartus dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial AT antjekurzidim dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial AT reinholdkreutz dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial AT joachimbeige dialysisassociatedhypertensiontreatedwithtelmisartandiatelapilotplacebocontrolledcrossoverrandomizedtrial
_version_	1718421303178821632

Dialysis-associated hypertension treated with Telmisartan--DiaTel: a pilot, placebo-controlled, cross-over, randomized trial.

Ejemplares similares