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Value of Combined Thiazide-Loop Diuretic Therapy in Chronic Kidney Disease: Heart Failure and Renin-Angiotensin-Aldosterone Blockade

机译:噻嗪环利尿剂联合治疗在慢性肾脏疾病中的价值:心力衰竭和肾素-血管紧张素-醛固酮阻滞

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摘要

Dussol and coworkers have provided clinically important information to refute the myth that thiazides are ineffective and should not be used in patients who are beyond stage 3 chronic kidney disease (CKD). The authors studied the relative effects of hydrochlorothia-zide and long-acting furosemide in individuals with stage 4 or 5 CKD and found that, while both drugs reduced blood pressure and enhanced natriuresis, the combination was superior to either component in both categories. These salutary effects occurred despite reduced glomerular filtration rate (GFR) and filtration fraction. In addition, they found a favorable effect on potassium balance in these patients with CKD: serum potassium was reduced from 4.9 mEq/L at baseline to 4.1 mEq/L during combination diuretic therapy.
机译:Dussol及其同事提供了重要的临床信息,以驳斥噻嗪类药物无效且不应用于3期以上慢性肾脏病(CKD)患者的说法。作者研究了氢氯噻嗪和长效呋塞米在CKD 4或5期个体中的相对作用,发现尽管两种药物均能降低血压和利尿作用,但两者的组合均优于两种成分。尽管降低了肾小球滤过率(GFR)和滤过率,但仍产生了这些有益的作用。此外,他们发现对这些CKD患者的钾平衡有有利影响:联合利尿剂治疗期间血清钾从基线时的4.9 mEq / L降低至4.1 mEq / L。

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