Hippokratia 2001, 5 (2): 61-68

G Vergoulas, Gr Miserlis, D Gakis, E Atmatzidis, A Antoniadis

Abstract

The aim of this study was to investigate the efficacy and safety of valsartan in the treatment of hypertension in patients with renal transplantation. Twenty three patients (18 men) on therapy with antihypertensive drugs were included in the study because of insufficient control of their blood pressure and/or drug side effects. These patients received valsartan at the dose of 80-160 mg/d. All patients in the study had serum creatinine level < 2.0 mg/dl before treatment with valsartan and a follow up six months before and six months after treatment. Systolic (SBP) and diastolic blood pressure (DBP), serum creatinine (Scr), Ht, Hb, uric acid and potassium were recorded every two months for a period of six months before (BVT) and six months after initiation of valsartan treatment (AVT). Proteinuria, number of antihypertensive agents, cyclosporine (CsA) dose and levels were recorded BVT (time 0) and six months later. Two patients stopped valsartan treatment because of serum creatinine elevation. ANOVA for repeated measures and paired t test were used for statistical analysis.SBP/DBP was 142.63+12.51/89.47±8.48 mmHg, 142.63±17.74/88.42±6.67 mm Hg, 144.47±11.53/ 92.63 ± 8.22 mmHg, 151.05±11.37/89.47±7.61 mmHg 6, 4, 2 and 0 months BVT respectively (p=NS) and 142.00±9.92/85.25±6.78 mmHg, 137.25±10.93/85.75±6.72 mmHg and 133.25±8.92/84.00±5.92 mmHg 2, 4 and 6 months AVT respectively (p=0.0001 for SBP). The number of antihypertensive agents per patient was 2.09±0.83/1.47±0.60 (p=0.001) at time 0 and six months after valsartan initiation. Scr was 1.30±0.34 mg/dl, 1.29±0.32 mg/dl, 1.31±0.33 mg/dl and 1.28+0.33 mg/dl 6, 4, 2 and 0 months BVT, respectively (p=NS) and 1.36±0.36 mg/dl, 1.40±0.37 mg/dl and 1,34±0.32 mg/dl 2, 4 and 6 months AVT initiation respectively (p=0.036). Ht/Hb were 40.47±6.26%/13.13±2.07g/dl, 40.78±6.39% /13.01±2.03g/dl, 4l.21±5.98% /13.22 ±2.01g/dl,41.77±6.04%/ 13.32 ± 2.02 g/dl 6, 4, 2 and 0 months BVT respectively (p=NS) and 38.65±6.10% / 12.65 ±1.93 g/dl, 38.65+6.10%/ 12.51±2.01 g/dl, 38.10+5.77%/12.55±2.10g/dl at 2, 4 and 6 months AVT initiation, respectively (p=0.001/ 0.022 respectively).In conclusion Valsartan offers a better control of blood pressure in patients with renal transplantation, lowers significantly the number of antihypertensive agents needed, causes a significant fall of Ht/Hb and a small but significant rise of serum creatinine level.

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