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The Kidney and Antihypertensive Therapy

  • Session IV: Problems in the Management of Hypertension
  • Chairman: Professor A.E. Doyle (Melbourne)
  • Published:
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Summary

Renal disease and hypertension is a continuing challenge to the nephrologist. At present there are few effective methods of dealing with the common renal diseases such as glomerulonephritis, but fortunately there is now a wide selection of potent antihypertensive agents. Drug resistant hypertension should be a rarity in clinical practice. Malignant hypertension remains a therapeutic emergency. If a patient with hypertension has renal functional impairment it is essential to lower the blood pressure to normal. In the presence of renal failure this should be done with caution so as to avoid a further deterioration in the glomerular filtration rate. However, if the blood pressure is controlled and especially if the renal failure is a result of hypertension alone, renal function may stabilise or even improve, often dramatically.

Recent experience with spironolactone, clonidine, prazosin,β-adrenoreceptor blockers and oral diazoxide is discussed together with the problem of hypertension in the patient with end-stage chronic renal failure.

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References

  • Bailey, R.R.: Qonidine (‘Catapres’) overshoot. New Zealand Medical Journal 81: 268–269 (1975).

    PubMed  CAS  Google Scholar 

  • Bailey, R.R.; Lynn, K.L. and Neale, T.J.: Prazosin in patients with hypertension and renal functional impairment (In preparation, 1976).

  • Bendali, M.J.; Baloch, K.H. and Wilson, P.R.: Side-effects due to treatment of hypertension and prazosin. British Medical Journal 2: 727–728 (1975).

    Article  Google Scholar 

  • Bufano, G. and Piacentini, L.: Studio comparativo dell’ influenza esercitata da agonisti e antagonisti betaadrenergici sulk funzione renale dell’ uomo normale. Minerva Medica 60: 1229–1232 (1969).

    PubMed  CAS  Google Scholar 

  • Eastwood, J.B.; Curtis, J.R. and Smith, R.B.: Pharmacoynamics of practolol in chronic renal failure. British Medical Journal 4: 320–322 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Frohlich, E.D.; Tarazi, R.C.; Dustan, H.P. and Page, I.H.: The paradox of beta-adrenergic blockade in hypertension. Circulation 37: 417–423 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Gillies, A.H.B.: Home haemodialysis in New Zealand. M.D. Thesis (in preparation), University of Otago.

  • Ibsen, H. and Sederberg-Olsen, P.: Changes in glomerular filtration rate during long term treatment with propranolol in patients with arterial hypertension. Clinical Science 44: 129–134 (1973).

    PubMed  CAS  Google Scholar 

  • Nayler, W.G.; Mclnnes, J.; Swann, J.B.; Carson, V. and Lowe, T.E.: Effect of propranolol, a beta-adrenergic antagonist, on blood flow in the coronary and other vascular fields. American Heart Journal 73: 207–216 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Neale, T.J.; Lynn, K.L. and Bailey, R.R.: Spironolactoneassociated aggravation of renal functional impairment. New Zealand Medical Journal (In press, 1976).

  • Pickering, G.: in High Blood Pressure, 2nd ed., p.450 (Churchill, London 1968).

    Google Scholar 

  • Pohl, J.E.F. Thurston,.: Use of diazoxide in hypertension with renal failure. British Medical Journal 4: 142–145 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Pohl, J.E.F.; Thurston, H. and Swales, J.D.: Oral diazoxide in resistant hypertension with renal impairment: Review of 100 cases. Proceedings of the Vth Interational Congress of Nephrology, Abst. No. 397 (1972).

  • Schirmeister, J.; Decot, M.; Hallauer, W. and Wiliman, H.: Beta-receptoren und renale hamodynamik des menschen. Arzneimittel Forschung 16: 847–850 (1966).

    PubMed  CAS  Google Scholar 

  • Shinebourne, E.; Fleming, J. and Hamer, J.: Effects of beta-adrenergic blockade during exercise in hypertension and ischaemic heart-disease. Lancet 2: 1217–1220 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Thompson, F.D.; Joekes, A.M. and Foulkes, D.M.: Pharmacodynamics of propranolol in renal failure. American Heart Journal 85: 427–428 (1973).

    Article  Google Scholar 

  • Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129mm Hg. Journal of American Medical Association 202: 1028–1034 (1967).

    Article  Google Scholar 

  • Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressure averaging 90 through 114mm Hg. Journal of American Medical Association 213: 1143–1152 (1970).

    Article  Google Scholar 

  • Warren, D.J.; Swainson, CP. and Wright, N.: Deterioration in renal function after beta-blockade in patients with chronic renal failure and hypertension. British Medical Journal 2: 193–194 (1974).

    Article  PubMed  CAS  Google Scholar 

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Bailey, R.R. The Kidney and Antihypertensive Therapy. Drugs 11 (Suppl 1), 70–77 (1976). https://doi.org/10.2165/00003495-197600111-00019

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  • DOI: https://doi.org/10.2165/00003495-197600111-00019

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