Summary
In an open study, thirteen chronic dialysis patients with nonvolume dependent uncontrolled hypertension were treated with pinacidil for a mean period of 43 weeks. Seven patients were taking concomitant antihypertensive therapy. Twelve patients achieved long-term blood pressure control on a mean dose of 33 mg/day. The baseline supine blood pressure was 184/116 mmHg. After 1 week it had fallen to 161/95 mmHg and blood pressure control was maintained over the study period.
Patient weight remained stable. The baseline reading was 61.6 kg and at the end of the study it was 59.7 kg. Pulse rate did not change significantly. For the eight patients not taking beta-blockers the mean change in pulse rate was 7.6 beats/min supine and 6.3 beats/min erect (NS). Pretrial urea and creatinine were 27.6 mmol/l and 1027 µmol/l and after 25 weeks they were 29.6 mmol/l and 1087 µmol/l, respectively (NS). Four patients had ECG evidence of left ventricular hypertrophy before the study and one on completion of the trial. Five patients showed correction of T-waves on their ECG's. Six patients experienced side effects, none of which warranted withdrawal of treatment. These findings suggest that pinacidil is a valuable alternative treatment for hypertensive dialysis patients.
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References
Arrigoni-Martelli E, Nielsen CK, Olsen UB, Petersen H (1980) “N-cyano-N-4-pyridyl-N`-1,2,2-trimethylpropylguanidine, monohydrate (P 1134): a new potent vasodilator. Experientia 36: 445–447
Blumberg A, Nelp WP, Hegstrom RM, Schribner BH (1967) Extracellular volume in patients with chronic renal disease treated for hypertension by sodium restriction. Lancet 2: 69–73
Carlsen J, Kardel T, Hilden T, Tango M, Trap-Jensen J (1981) Immediate central and peripheral haemodynamic effects of P 1134, a new vasodilating agent in hypertensive man. Clin Physiol 1: 375–384
Carlsen JE, Kardel T, Lund JD, Trap-Jensen J (1983) Immediate haemodynamic effects of pinacidil and hydralazine in essential hypertension. A double-blind randomized crossover study. J Hypertens 1 [Suppl 2]: 356–359
Carlsen JE, Kardel T, Jensen HE, Tango M, Trap-Jensen J (1983) Pinacidil, a new vasodilator: pharmacokinetics and pharmacodynamics of a new retarded release tablet in essential hypertension. Eur J Clin Pharmacol 25: 557–561
Charra B, Calemard E, Cuche M, Laurent G (1983) Control of hypertension and prolonged survival on maintenance haemodialysis. Nephron 33: 96–99
Eilertsen E, Magnussen MP, Petersen HJ, Rastrup-Andersen N, Sorensen H, Arrigoni-Martelli E (1982) Metabolism of the new antihypertensive agent pinacidil in rat, dog and man. Xenobiotica 12: 187–196
Flouvat B, Decourt S, Potaux L (1979) Pharmacocinetique du propranolol chez l'insuffisant renal hemodialyse. Therapie 34: 63–72
Hall D, Charcopos F, Froer KL, Rudolph W (1979) ECG changes during long-term minoxidil therapy for severe hypertension. Arch Intern Med 139: 790–794
Hall D, Froer KL, Rudolph W (1980) Serial electrocardiographic changes during long-term treatment of severe hypertension with minoxidil. J Cardiovasc Pharmacol 2 [Suppl 2]: S200-S205
Harter HR, Tindira C, Delmez JA (1981) Blood pressure control in haemodialysis patients: the long-term effects of prazosin. J Cardiovasc Pharmacol 3: 49–57
Hull AR, Long DL, Prati RC, Pettinger WA, Parker TF III (1975) The control of hypertension in patients undergoing regular maintenance haemodialysis. Kidney Int 17 (Suppl 2): 184–187
Kanada SA, Kanada DJ, Hutchinson RA, Wu D (1976) Anginalike syndrome with diazoxide therapy for hypertensive crisis. Ann Intern Med 84: 696–700
Lilley JJ, Golden J, Stone RA (1976) Adrenergic regulation of blood pressure in chronic renal failure. J Clinc Invest 57: 1190–1200
Linder A, Charra B, Sherrard DJ, Schribner BH (1974) Accelerated atherosclerosis in prolonged maintenance haemodialysis. N Engl J Med 290: 697–701
Linder A, Douglas SW, Adamson JW (1978) Propranolol effects in long-term haemodialysis patients with renin dependent hypertension. Ann Intern Med 88: 457–462
Mackay A, Isles C, Hendersen I, Fife R, Kennedy AC (1981) Minoxidil in the management of intracetable hypertension. Q J Med 198: 175–190
Mahony YF, Storey BG, Gibson GR, Stokes GS, Sheil AGR, Stewart JH (1972) Bilateral nephrectomy for malignant hypertension. Lancet 1: 1036–1038
Olsen UB, Arrigoni-Martelli E (1983) Vascular effects in dogs of pinacidil (P 1134), a novel vasoactive antihypertensive agent. Eur J Pharmacol 88: 389–392
Petersen HJ, Nielsen CH, Arrigoni-Martelli E (1978) Synthesis and hypotensive activity of N′-alkyl-N″-cyano-N′ pyridyl guanidines. J Med Chem 21: 773–781
Rao TKS, Gupta SK, Butt KMH, Kountz SO, Friedman EA (1978) Relationship of renal transplantation to hypertension in end stage renal failure. Arch Intern Med 133: 1236–1241
Roux A, Aupert P, Guedon J, Flouvat B (1980) Pharmacokinetics of acebutolol in patients with all grades of renal failure. Eur J Clin Pharmacol 17: 339–349
Vertes V, Cangiano JL, Berman LB, Gould A (1969) Hypertension in end stage renal disease. N Engl J Med 280: 978–981
Weidmann P, Maxwell MH, Lupu AN, Lewin AJ, Massry SG (1971) Plasma renin activity and blood pressure in terminal renal failure. N Engl J Med 285: 757–762
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Breen, E.G., Mulhall, D. & Keogh, J.A.B. Long-term effects of pinacidil in hypertensive dialysis patients. Eur J Clin Pharmacol 28, 375–380 (1985). https://doi.org/10.1007/BF00544353
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DOI: https://doi.org/10.1007/BF00544353