| ObjectiveTo observe the therapeutic effects and the satety of angiotensin Ⅱ type1receptor blockers(ARB) in patients with chronic kidney disease(CKD) stage4.MethodDuring the July1,2011to October31,2011, a total of48hospitalized patients with chronic kidney disease stage4were treated in.48patients were divided into two groups randomly. Valsartan was given(80or160mg/d) as an intervention for the experimental group. Additionnal calcium channel antagonist and/or β-blocker and/or a blocker were used for blood control. Patients in the control group just took calcium channel antagonist and/or β-blocker and/or a blocker but not renin-angiotensin system inhibitor. The target blood pressure was125/75mmHg. We observed the clinical index (blood pressure, urinary protein, serum uric acid, cholesterol, triglyceride, hemoglobin, serum creatinine, potassium) during the8-week treatment. A sharp rise of serum creatine (by30percent) and hyperkalemia (>5.7mmol/L) and unbearable cough were regarded as the end point of the trial.Results1.Changes in the blood pressurePatients in both of the two groups all got good blood control. The percentages of cases reaching the target were the experimental group45.0%and the control group 40.0%. There was no significant difference among them(P>0.05).2.Changes in the urinary proteinThe urinary protein all reduced in the two groups until the eighth weekends. But the magnitude in the experimental group was much higher than the other.3.Changes in other indexTo the8th weekend, both of the two groups had a lower level of uric acid and a higher level of hemoglobin. The level of cholesterol and triglyceride didn’t change. There was no significant difference among them.4.Safety analysisBy the end of the trial, none of the patients had reached the end point. There was no significant difference between the two groups at any time points. At the first weekend, the potassium level of the treatment treatment group was obviously higher than the other. But there was no statistical difference between them at the other time points. No unbearable cough and headache was observed.ConclusionsUnder close monitoring, it is safe for patients with CKD4to use ARB. It shows good therapeutic effect in such patiens. |
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