Pharmacokinetics and Efficacy of Carvedilol in Hypertensive Patients with Chronic Renal Failure and Hemodialysis Patients

Masumura, Hidemi; Miki, Shigehiro; Kaifu, Yasuo; Kitajima, Waichi; Abe, Youichi

doi:10.1097/00005344-199219001-00020

Cited by 20 publications

(7 citation statements)

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“…In the further classification of the patients in the carvedilol group, the cumulative defined daily dose that was usually used in past NHIRD studies was not used because carvedilol can be excreted by the liver within 24 hours and does not accumulate in patients. 13 Moreover, not only our own clinical experiences but also previous studies have shown that the daily doses of carvedilol actually received by patients are often far less than the defined daily dose (37.5 mg). 14,15 Therefore, the total number of days of receiving carvedilol was used for grouping the patients in the carvedilol group for the multivariate analysis.…”

Section: Groupingmentioning

confidence: 92%

Effect of carvedilol on arteriovenous graft primary patency

et al. 2020

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Background The major mechanisms of arteriovenous graft (AVG) failure due to intimal hyperplasia (IH) are smooth muscle cell proliferation and inflammation. Therefore, carvedilol may improve AVG primary patency because of its anti-proliferative and anti-inflammatory activities. Methods The data of end-stage renal disease patients receiving regular hemodialysis were collected from the National Health Insurance Research database. The end point was the first percutaneous transluminal angioplasty (PTA) for AVG failure or death during a follow-up period of two years or the end of 2013. The analysis was calculated with Cox proportional hazard model. Results There were 3028 patients treated with carvedilol and 13,704 patients not treated with carvedilol. According to a univariate analysis, the carvedilol group was younger, received more anti-hypertensive medications and platelet aggregation inhibitors, and had higher rates of diabetes mellitus and hyperlipidemia but had lower rates of hypotension and smoking. According to a multivariate analysis, after controlling for covariates, the use of carvedilol for more than 84 days reduced the probability of a first PTA for AVG failure by 9% compared with no use of carvedilol ( p = 0.021), but the use of carvedilol for 1 to 84 days did not. Conclusion The results of this study indicate that the use of carvedilol for more than 84 days improves the primary patency of AVGs, but the use of carvedilol for less than 84 days does not.

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Section: Groupingmentioning

confidence: 92%

Effect of carvedilol on arteriovenous graft primary patency

et al. 2020

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“…Lastly, our study did not investigate the interdialytic pharmacokinetics of the four b-blockers. Previous studies have shown that the t 1/2 and kidney clearances of these drugs on nondialysis days return to values that are comparable with those of patients with ESKD not yet on RRT (32,37,(48)(49)(50).…”

Section: Discussionmentioning

confidence: 85%

β-Blocker Dialyzability in Maintenance Hemodialysis Patients

Tieu¹,

Velenosi²,

Kucey³

et al. 2018

CJASN

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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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Pharmacokinetics and Efficacy of Carvedilol in Hypertensive Patients with Chronic Renal Failure and Hemodialysis Patients

Cited by 20 publications

References 0 publications

Effect of carvedilol on arteriovenous graft primary patency

Effect of carvedilol on arteriovenous graft primary patency

β-Blocker Dialyzability in Maintenance Hemodialysis Patients

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

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