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In patients with normal blood pressure nephropathy, these tw
Why you don’t have hypertension, but doctors often prescribe antihypertensive drugs, one, two, or even more? Why every index control is very good, still continue to take antihypertensive medicine? Because the antihypertensive drugs are not only used to lower blood pressure, but also to reduce urinary protein and protect kidney function.
There are a lot of antihypertensive drugs, but they can reduce urine protein, protect kidney function, and the most commonly used antihypertensive drugs in nephrology are priapril and sartan. Reduce glomerular filtration protein, block RAS system, antagonize renal sclerosis, play its role of reducing proteinuria and protecting renal function.
For those of you who have proteinuria but don't take cyclosporine, these two drugs are the first choice for immunosuppressants such as tacrolimus. But patients often have problems with low blood pressure. After taking antihypertensive drugs, blood pressure was lowered too much; blood pressure was elevated and only sartan or priapril was taken, so the blood pressure control effect was not satisfactory.
More than 80% of confirmed nephrotic patients have elevated blood pressure, and hypertension can lead to faster progression to uremia in patients with nephropathy, so nephrotic patients should strictly control their blood pressure within a reasonable range. The higher the dosage, the more obvious the effect of reducing proteinuria is, so nephrologists often try higher doses when using these two drugs. For patients whose blood pressure is not smoothly controlled (too high or too low), the dosage or combination of drugs should be adjusted.
Priapril can cause irritating coughs among some of your kidney friends, and you need to switch to sartan if necessary. Both priapril and sartan have the effect of increasing serum potassium. Patients should monitor the level of serum potassium in order to avoid the occurrence of hyperkalemia. It can also be used in conjunction with diuretics with potassium excretion to neutralize blood potassium levels.
The level of serum creatinine was affected by priapril or sartan. When the creatinine increased by less than 30% of the original creatinine (100 μ mol / L before administration, the highest level was 130 μ mol / L) after taking the drug, it was a normal phenomenon for the drug to exert its effect, although the serum creatinine increased. But to protect kidney function is beneficial, cannot stop medicine blindly at this time.
But when the creatinine level is more than 30 percent, or even more than 50 percent (more than 130 μ mol / L), you can't continue taking it, stop looking for the cause, and correct it in time.
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