Pharmacokinetics and Efficacy of Carvedilol in Chronic Hemodialysis Patients with Hypertension

Miki, Shigehiro; Masumura, Hidemi; Kaifu, Yasuo; Yuasa, Shigekazu

doi:10.1097/00005344-199106184-00013

Cited by 13 publications

(14 citation statements)

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“…Patients with renal disease have slightly increased plasma carvedilol concentrations 25 ; the pharmacokinetics of carvedilol are not altered in patients undergoing hemodialysis. 26 Drugs that increase cytochrome P-450 activity, such as rifampin, can accelerate the clearance of carvedilol. Hydrochlorothiazide does not influence the pharmacokinetics of carvedilol, 9 and the pharmacokinetics of warfarin are not affected by carvedilol.…”

Section: Pharmacodynamic and Pharmacokinetic Propertiesmentioning

confidence: 99%

Carvedilol

1998

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Section: Pharmacodynamic and Pharmacokinetic Propertiesmentioning

confidence: 99%

Carvedilol

1998

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“…For example, amiodarone is extensively metabolized in the liver and excreted with bile, so there is no need to modify its dosage according to creatinine clearance. In contrast, to avoid higher serum concentrations of carvedilol in patients with renal failure, it is necessary to reduce its dosage [9][10][11]. In patients with chronic renal failure, particularly those on hemodialysis, there are many factors which may trigger and influence on the incidence of cardiac arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Recurrent atrioventricular nodal re-entrant tachycardia treated with percutaneous ablation in a 75-year old patient undergoing intermittent hemodialysis

Ratajewska

Banachowicz²,

Grzegorzewska³

2008

Int Urol Nephrol

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A 75-year old man with long-term arterial hypertension was diagnosed in 1998 with stage 3 chronic kidney disease due to hypertensive nephropathy. Since May 2004 the patient has been treated with intermittent hemodialysis. Since 1998 he has been hospitalized several times because of palpitations in the course of paroxysmal tachycardia with narrow QRS complexes. Initially, class I antiarrhythmic agents were administered; afterwards therapy with beta-adrenolytics was introduced. Because of the ineffectiveness of monotherapy, beta-adrenolytic therapy was combined with amiodarone; however, side effects of this treatment in a form of drug-induced bradycardia appeared. During an invasive electrophysiological investigation, a typical recurrent atrioventricular nodal reentrant tachycardia (AVNRT) was repeatedly released. Subsequently performed percutaneous ablation resulted in effective modification of the slow pathway. During 25 months of follow up after the procedure, recurrence of AVNRT was not observed. Effectiveness of ablation and low risk of adverse effects in non-dialyzed patients encourage us to recommend this method of AVNRT treatment also in patients undergoing intermittent hemodialysis.

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“…Lipophilic agents, for example, carvedilol, undergo hepatic clearance, have long half‐lives, and penetrate the blood–brain barrier. They are not cleared on HD (67). Hydrophilic agents such as atenolol are cleared by the kidneys, have a short half‐life, and accumulate in renal failure.…”

Section: Potential Impediments To β‐Blocker Use In Dialysis Patientsmentioning

confidence: 99%

The Intuitive Case for β‐blockers in Patients with ESRD

McQuillan

Chan

2012

Seminars in Dialysis

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Sudden cardiac death (SCD) is common in dialysis patients accounting for up to 25% of all-cause mortality. Unlike in the general population, occlusive coronary artery disease is implicated in a minority of these deaths. Activation of the sympathetic nervous system is prevalent in the dialysis population and may underlie this high rate of SCD. β-blockers reduce SCD in the general population and, given their mode of action, β-blockers would seem to be an ideal class of agents to prevent SCD in dialysis patients. In this review, we will explore the etiology of SCD in dialysis patients and discuss the evidence supporting the use of β-blockers in patients with ESRD. We will also examine potential impediments to the use β-blocker in the dialysis population and outline directions for future trials in this area.

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Pharmacokinetics and Efficacy of Carvedilol in Chronic Hemodialysis Patients with Hypertension

Cited by 13 publications

References 0 publications

Carvedilol

Carvedilol

Recurrent atrioventricular nodal re-entrant tachycardia treated with percutaneous ablation in a 75-year old patient undergoing intermittent hemodialysis

The Intuitive Case for β‐blockers in Patients with ESRD

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