Терапевтический архив (May 2013)
Effect of a fixed-dose perindopril and amlodipine combination on intrarenal hemodynamic and kidney functional parameters in patients with essential hypertension
Abstract
AIM: To evaluate the effect of prestans on intrarenal hemodynamic and kidney functional parameters and to study their correlations during 24-week therapy in patients with grade I-II essential hypertension (EH)/MATERIAL AND METHODS: Eighty-two patients (44 men and 38 women) with EH were examined and allocated to 3 groups according to glomerular filtration rate (GFR): 1) 31 patients with a GFR of >90 ml/min/1.73 m2; 2) 28 with a GFR of 60-89 ml/min/1.73 m2; 3) 23 with a GFR of 59-30 ml/min/1.73 m2/RESULTS: Group 3 patients were found to show a preponderance of metabolic disturbances, such as dyslipidemia, obesity, as well as intrarenal arterial lesions and diminished kidney function. In addition, the most pronounced therapy-induced changes in the parameters under study were also observed in Group 3. In particular, resistive index, pulsatility index of interlobar arteries of the kidneys, and serum creatinine levels increased, the frequency of microalbuminuria episodes reduced, and GFR, endothelium-dependent dilation of the brachial artery, and systolic index rose statistically significantly. Group 3 also displayed statistically significant correlations of the resistive index of the interlobar arteries with GFR, urinary albumin excretion, endothelium-dependent vasodilation, and cardiac index/CONCLUSION: The fixed-dose perindopril and amlodipine combination in patients with EH and hypertensive nephropathy improves intrarenal hemodynamics and exerts marked nephroprotective and antihypertensive effects.
