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埼玉医科大学雑誌 第30巻 第2号 (2003年4月) 163-170頁 ◇論文(図表を含む全文)は，PDFファイルとなっています． PDF (876 KB) 原 著 降圧薬の腹膜機能に及ぼす影響：人および実験動物での検討 友利 浩司 埼玉医科大学腎臓内科学教室〔平成15年3月10日 受付〕 Effects of Antihypertensive Drugs on Peritoneal Function in Human and Experimental Animals Koji Tomori (Department of Nephrology, Saitama Medical School, Moroyama, Iruma-gun, Saitama 350-0495, JAPAN) Antihypertensive therapy for the patients receiving continuous ambulatory peritoneal dialysis (CAPD) has been carried out without any guideline or clear results of large scale study. To investigate the effects of antihypertensive agents on peritoneal function, animal experiment and clinical observation were carried out. ＜Study1＞ Renovascular hypertension in dogs was induced with silver clips on both renal arteries that created 90% occlusion. After confirmation of elevation of blood pressure, usually 20 days after operation, the abdomen was opened while the animals were under general anesthesia. Using a CCD camera, diameters of the small arteries of the peritoneum were measured after oral administration of placebo (n＝5); 8 mg of CS866, a selective angiotensin II type I receptor blocker (n＝5); 10 mg of temocapril, an angiotensin converting enzyme inhibitor (n＝5); or 10 mg of amlodipine, a calcium antagonist (n＝5). Blood pressure was decreased in dogs with CS866 and a similar decrease was observed with the use of other drugs. The diameter of the small vessels was increased in dogs with CS866 and temocapril, respectively, compared with the calcium antagonist.＜Study2＞ The effects of valsartan, on blood pressure, dialysate volume, and residual renal and peritoneal function in 36 CAPD patients before and 3 months after oral administration valsartan 40-80 mg daily were investigated comparing with amlodipine. Blood pressure was decreased significantly. Drain volume in peritoneal dialysis and a weekly peritoneal creatinine clearance was significantly increased. No significant changes in serum creatinine and hemoglobin were observed in both groups. In conclusion, these data clearly demonstrated that the blockade of the renin-angiotensin system produces an increase in solute clearance in hypertensive dogs with mild renal insufficiency. These data indicate that such blockade may be applicable as therapy for hypertensive patients on CAPD. Keywords: angiotensin type 1 receptor blocker, calcium antagonist, peritoneal function, hypertension J Saitama Med School 2003;30:163-170 (Received March 10, 2003)
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