30 October 1998
Cardiovascular agents in renal diseases
Zofia WańkowiczMed Sci Monit 1998; 4(6): RA1104-1110 :: ID: 501946
Abstract
Cardiovascular diseases are main, potentially lethal, complications of renal diseases. When using cardiovascular drugs, one should take into consideration the following factors:
- the close cause-effect relationship between cardiac and renal diseases.
- polymorphism of cardiologic complications.
- multiple 'nephrogenic' factors that determine the occurrence of cardiologic complications and their resistance towards standard cardiologic agents. These factors include: hyperkaliemia and hypokaliemia, hypercalcemia and hypocalcemia, hypomagnesemia, metabolic acidosis;
- nephrogenic anemia, secondary hyperparathyroidism, lipid disturbances, hypoproteinemia, coexistent liver damage;
- modifying effect of uremia and dialysis therapy on the pharmacodynamics of cardiologic drugs.Since an ideal cardiological agent is unavailable and the correlation between renal elimination of cardiac drugs and the rate of glomerular filtration remains approximate, cardiac drug doses should be chosen individually, depending on the patients hemodynamic condition, degree of renal failure, evidence of drug cumulation and its blood concentration level. One of the tables is attached, presents cardiac drugs which may be given to patients with renal failure following maintenance dose modification. It is also worth mentioning that cardiac drugs should be administered in full saturating doses in patients with renal failure, and maintenance doses should be modified in such a way as to ensure a stable drug blood level. This may be achieved by reduction of single doses instead of time gap prolongation between standard doses. This study presents a review of cardiovascular drugs taking into consideration their potential benefits as well as potential renal damage with special reference towards: inotropic drugs, antiarrhythmic drugs, adenosine (Adenocor), ACE inhibitors, nitrates, antiplatelet and fibrinolytic drugs, as well as new cardioprotective agents. Presented here, are case reports of successfully treated severe cardiovascular complications in patients with renal failure.
Keywords: renal failure, Dialysis, Cardiovascular Agents
818 0
Editorial
01 November 2023 : Editorial
Editorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is DeclaredDOI: 10.12659/MSM.942960
Med Sci Monit 2023; 29:e942960
In Press
28 Nov 2023 : Clinical Research
Impact of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography on Therapeutic Decisions and ...Med Sci Monit In Press; DOI: 10.12659/MSM.942122
28 Nov 2023 : Clinical Research
Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children...Med Sci Monit In Press; DOI: 10.12659/MSM.943031
27 Nov 2023 : Clinical Research
Comparison of Outcomes from Emergency Admissions to a Major Trauma Center in Turkey of 1646 Elderly Patient...Med Sci Monit In Press; DOI: 10.12659/MSM.942916
27 Nov 2023 : Clinical Research
Evaluating Modified Ultrasound-Guided Serratus Anterior Plane Block for Enhanced Postoperative Recovery in ...Med Sci Monit In Press; DOI: 10.12659/MSM.942757
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292