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- Juhlin, TordLund University,Lunds universitet,Kardiologiska klinikens forskargrupp,Forskargrupper vid Lunds universitet,Cardiology Research Group,Lund University Research Groups (författare)
Cyclooxygenase inhibition causes marked impairment of renal function in elderly subjects treated with diuretics and ACE-inhibitors
- Artikel/kapitelEngelska2005
Förlag, utgivningsår, omfång ...
- 2007-07-27
- Wiley,2005
- printrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:uu-104670
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104670URI
- https://doi.org/10.1016/j.ejheart.2004.10.005DOI
- https://lup.lub.lu.se/record/144621URI
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- Språk:engelska
- Sammanfattning på:engelska
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Klassifikation
Anmärkningar
- BACKGROUND: Treatment with angiotensin-converting enzyme (ACE)-inhibitors is known to cause an initial reduction in glomerular filtration rate (GFR) in patients with congestive heart failure. The long-term beneficial effects of ACE-inhibitors in these patients can be counteracted by cyclooxygenase-inhibitors. AIMS: To quantify the negative renal effects of the cyclooxygenase-inhibitor diclofenac in elderly healthy subjects and to assess how treatment with an ACE-inhibitor, after activation of the renin-angiotensin system, influences these renal effects. METHODS: Fourteen elderly, healthy subjects received oral diclofenac and placebo in a double-blind cross-over fashion. The study was divided in two parts; in part one, subjects received no pre-treatment and in part two, the subjects were given pre-treatment with bendroflumethiazide and enalapril in order to activate the renin-angiotensin system. RESULTS: Diclofenac induced significant (p<0.05) decreases in GFR, urine flow, excretion rates of sodium and potassium, electrolyte clearance, osmolality clearance and free water clearance both with and without renin-angiotensin system activation. Least square means (95% CI) of all observations during the first 6 h after dosing showed that diclofenac caused a reduction in GFR from 71 (64-78) to 59 (52-66) ml/min. After pre-treatment, diclofenac further reduced GFR from 60 (52-67) to 48 (40-55) ml/min. After diclofenac administration, urine flow fell from 7.4 (6.4-8.3) to 5.1 (4.2-6.1) ml/min, after pre-treatment, diclofenac gave a further reduction from 4.1 (3.1-5.1) to 2.2 (1.3-3.2) ml/min. More than half of the reductions were caused by the pre-treatment. CONCLUSION: Renal function in elderly, healthy subjects is impaired after acute intake of diclofenac. This impairment is observed both with and without activation of the renin-angiotensin system and ACE-inhibitor treatment but is more pronounced after pre-treatment.
Ämnesord och genrebeteckningar
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
- ACE-inhibitors
- NSAIDs
- heart failure
- renal function
- glomerular filtration rate
- MEDICINE
- MEDICIN
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Björkman, SvenUppsala universitet,Avdelningen för farmakokinetik och läkemedelsterapi,Hammarlund-Udenaes (författare)
- Höglund, PeterLund University,Lunds universitet,Avdelningen för klinisk kemi och farmakologi,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Clinical Chemistry and Pharmacology,Department of Laboratory Medicine,Faculty of Medicine(Swepub:lu)kfar-pho (författare)
- Kardiologiska klinikens forskargruppForskargrupper vid Lunds universitet (creator_code:org_t)
Sammanhörande titlar
- Ingår i:European Journal of Heart Failure: Wiley7:6, s. 1049-10561388-98421879-0844
Internetlänk
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1016/j.ejheart.2004.10.005
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16227143&dopt=AbstractFULLTEXT
- http://dx.doi.org/10.1016/j.ejheart.2004.10.005FULLTEXT
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104670
- https://doi.org/10.1016/j.ejheart.2004.10.005
- https://lup.lub.lu.se/record/144621
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- European Journal of Heart Failure (Sök värdpublikationen i LIBRIS)
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