The Clinical Observation On Effect Of Telmisartan On The Residual Renal Function And Peritoneal Function In Peritoneal Dialysis Patients

Objective To observe whether the angiotensin Ⅱ receptor blocker(ARB), telmisartanon peritioneal function and whether the ARB can slow the decline of residual renalfunction in patients on peritoneal dialysis.Methods Between June2010and June2011，all new ESRD patients who receivedmaintenance peritoneal dialysis (PD) in our hospital were recruited.Patient’s age,gender,PD prescription,and medical conditions were recorded．46-peritoneal dialysispatients of coforming to the conditions were randomly evenly divided into ARB studygroup and control group. The subjects on ARB study group were administered80mgTelmisartan daily. Through antihypertensive therapy, the target blood pressure of twogroups of patients will reach16~18/9.33~11.33kPa within the12-month observationperiod. In all patients the eGFR were dectected every three months. The levels ofalbumin, cholesterol, triglyceride and low density lipoprotein, Kt/V, CCL, and bloodpressure,24hours urinary volume were detected also before and after the experiment.At the same time，testing the VEGF expression of peritoneal dialysis fluid before andafter treatment for one month by ELASE method.Results1.A total of68patients were included in this study,and44patients had the informationwe needed． 2.Over12month, the urine volume and residual renal function both were decreased oncontrol group, but did not reach the significant level(P>0.05), which on ARB studygroup, these two parameters all declined significantly,(P<0.05).3.Overall, compared with controls,the cholesterol, triglyceride and low densitylipoprotein were all declined on ARB study group, but did not reach the significantlylevel,(P>0.05).4.The expression of vascular endothelial growth factor in peritoneal dialysis fluid wereincreased in both groups with the dialysis time, but it increased significantly in thecontrol group (P<0.05).The ARB study group is not statistically significant,(P>0.05).Conclusion1．With the dialysis time,the urine volume and residual renal function of continuousambulatory peritoneal dialysis were all decreased.2. Comparing with other antihypertensive drugs, Telmisartan may protect the residualrenal function and peritioneal function in patients with regular peritoneal dialysis.3. The ARB drugs may reduce VEGF expression.It can reduce peritoneal angiogenesis andextracellular matrix accumulation, in order to delaying the development of peritoneal dialysiscorrelation of peritoneal fibrosis.