Showing papers by "Luis M. Ruilope published in 1982"

Role of the control of phosphate in the progression of chronic renal failure.

Abstract: In order to control the progression of chronic renal failure through the maintenance of low-normal levels of serum phosphate, 10 patients (group I) were followed over a period of 10 months. They were maintained on a low phosphate diet and 12 g/day of aluminum hydroxide. Under this treatment, the serum phosphate decreased significantly compared to the phosphate levels determined prior to initiation of treatment, and compared to the serum phosphate levels of 10 controls with the same degree of renal failure (group II) but receiving conventional treatment. Despite the maintenance of normal levels of serum phosphate in group I, serum creatinine increased in the same proportion as in group II. A paired t test did not show any difference between the progression of the renal failure before or after the control of serum phosphate.

Role of renal prostaglandin E2 in chronic renal disease hypertension.

Abstract: The role played by renal prostaglandin E2 in the maintenance of hypertension in chronic renal disease has been investigated through studying the response of body weight, blood pressure, glomerular filtration rate (GFR), 24-hour natriuresis, plasma renin activity (PRA), plasma aldosterone and urinary PGE2 excretion to the administration of indomethacin (2mg/kg daily, during 3 days). A group of 37 patients diagnosed as having chronic renal parenchymatous disease with creatinine clearance above 25 ml/min was included in the study. 21 of them were hypertensive (BP greater than 160/95). 27 normotensive volunteers were also studied and considered as the control group. The initial study disclosed similar levels of PGE2, PRA and plasma aldosterone in volunteers, normotensive patients and hypertensive patients, although the sodium intake was lower in the last two groups. A positive correlation between PRA and urinary PGE2 was found both in normotensive (r = 0.507, p less than 0.01) and in hypertensive patients (r = 0.609, p less than 0.01). The administration of indomethacin induced a diminution of PRA, plasma aldosterone and urinary PGE2 levels together with an increase in diastolic blood pressure (p less than 0.05-0.01) in both volunteers and patients. The remaining parameters measured did not change in volunteers or in normotensive patients. On the contrary, in hypertensive patients, during indomethacin administration, lower values of creatinine clearance (p less than 0.005) and 24-hour natriuresis (p less than 0.05) together with an increase in body weight (p less than 0.01) were observed. These results point to the existence of a protective role of renal prostaglandin E2 upon renal function when hypertension appears in the course of chronic renal parenchymatous disease.

The role of urinary PGE2 and renin-angiotensin-aldosterone system in the pathogenesis of essential hypertension.

Abstract: In a group of 26 patients diagnosed as essential hypertensive (EH) and in a control group (CG) of 27 normotensive volunteers the urinary excretion of PGE2, plasma renin activity (PRA) and plasma aldosterone were measured. EH patients were classified into normoreninemic (NREH) (n=21) and hyporeninemic(LREH) (n=5) by the response of PRA to the combined stimuli of ambulation and furosemide. Urinary PGE2 excretion was higher in NREH than in CG (p<0.05) while LREH showed values lower than in CG(p<0.001). Plasma aldosterone levels were similar in the three groups. In CG and EH patients PRA and urinary PGE2 were closely related (CG r=0.516, p<0.05, EH patients r=0.674, p<0.001).Indomethacin administration induced a decrease of PGE2 in both CG (n=8) and NREH (n=8) (p<0.01). In contrast, indomethacin induced no changes in PGE2 excretion of LREH (n=5). Furthermore in the group of patients with NREH indomethacin induced a significant increase in blood pressure (p<0.01) and body weight (p<0.01) while glomerular filtr...