Original scientific paper
Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in the Early Period after Kidney Transplantation
Lidija Orlić
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Ivana Mikolašević
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Branka Sladoje-Martinović
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Ivan Bubić
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Martina Pavletić-Peršić
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Sanjin Rački
; University of Rijeka, University Hospital Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia
Abstract
The role of renin-angiotensin system inhibitors (ACE-inhibitors) or angiotensin receptor blockers (ARB) in the renal transplant recipients (RTRs) is incompletely defined and according to the current guidelines they should be initiated af- ter six months post-transplantation. The aim of the present paper is to evaluate the efficiency and safety of early (within six months post-transplantation) versus late (after six months post-transplantation) initiation of ACE-inhibitors or ARB in RTRs. The study group compromised of 108 RTRs (50 male and 58 female) who received a kidney transplant. Beside other prescribed antihypertensive drugs all of them took and ACE inhibitors or ARB in order to achieve blood pressure control. For this analysis purpose, recipients were stratified into two groups according to the time of ACE inhibitors/ARB initiation into early (within six months post-transplantation) and late (after six months after transplantation) group. For each patient haemoglobin, serum creatinine and potassium levels were analyzed at the beginning of ACE inhibitors/ARB introduction and at the end of the first, third, sixth and twelfth month. In the 54 (50%) of the 108 patients ACE inhibi- tors/ARB were initiated within six months post-transplantation and in 49 (90.7%) of them within three months (in 29 pa- tients within one month; in 13 within two months; in 7 within 3 months) post-transplantation. In additional 54 (50%) patients ACE inhibitors/ARB were initiated, but after six months post-transplantation. There was no statistically signifi- cant difference between the two groups related to age or gender and due to the duration of dialysis treatment before the transplantation. Analyzing the haemoglobin, creatinine and potassium serum levels after initiation of therapy with ACE inhibitors/ARB trough observed period we did not found any statistically significant difference in all measured parame- ters between the two groups of patients and also within the same group of patients. Therefore, according to experience from our Institution early initiation of ACE inhibitors or ARB appears to be safe in carefully selected recipients with rela- tively good early graft function.
Keywords
renin-angiotensin system; angiotensin receptor blockers; renal transplant recipients; arterial hyperten-sion; prescribe
Hrčak ID:
118269
URI
Publication date:
30.9.2013.
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