Inappropriate use of urinary catheters and its common complications in different hospital…

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Efficacy of low dose spironolactone in chronic kidney disease with resistant hypertension.

Saudi J Kidney Dis Transpl. 2011 Jan;22(1):75-8

Authors: Abolghasmi R, Taziki O

To determine the antihypertensive benefit of adding low dose sprinolactone to multi-drug regimens that included a diuretic, a calcium channel blocker and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in patients with moderately severe chronic kidney disease (CKD) [glomerular filtration rate (GFR) 25-50 mL/min] and resistant hyper-tension, we studied 41 patients randomly divided into two groups: group 1: patients who received placebo as spironolactone and group 2: patients who received spironolactone 25-50 mg/day. The patients were evaluated during follow-up at the 6th and 12th weeks. The mean decrease in systolic and diastolic blood pressure after 6 weeks of spironolactone was 33 ± 8 and 13 ± 2 mmHg, respectively, and it was maintained after 12 weeks of spironolactone wherein the values were 36 ± 10 and 12 ± 2 mmHg, respectively, while there was no change in the blood pressure in the control group. Hyperkalemia (serum potassium >5.5 meq/L) occurred in one subject in the spironolactone group. We conclude that low-dose spironolactone may provide a significant additive blood pressure reduction in CKD patients (stage 2 and 3) with resistant hypertension.

PMID: 21196617 [PubMed - indexed for MEDLINE]

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Renal replacement therapy in sepsis-induced acute renal failure.

Saudi J Kidney Dis Transpl. 2009 Jul;20(4):553-9

Authors: Rajapakse S, Rodrigo C, Rajapakse A, Kirthinanda D, Wijeratne S

Acute renal failure (ARF) is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT) during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

PMID: 19587493 [PubMed - indexed for MEDLINE]

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