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Biomedical subjects

H Mulec

Publications and source records attributed to H Mulec.

25 records · Page 2Linked to original sources
PubMed1986

Beneficial effects of angiotensin converting enzyme inhibition on renal function in patients with diabetic nephropathy.

The effects of angiotensin converting enzyme inhibition with captopril were investigated in patients with diabetic nephropathy and hypertension. After nine days' treatment with captopril glomerular filtration rate was unchanged in 13 patients, whereas renal plasma flow had increased from 265 to 302 ml/min/1.73 m2 body surface area (p less than 0.05) and the filtration fraction had decreased from 14.3 to 12.8% (p less than 0.025). During two years' treatment with captopril in 14 patients the mean arterial blood pressure had fallen by 5 mm Hg (p less than 0.005) and the deterioration in glomerular filtration rate had decreased from 10.3 to 2.4 ml/min/year (p less than 0.005). There was no correlation between the fall in blood pressure and the reduction in the deterioration of glomerular filtration rate. These findings suggest that the effects of angiotensin converting enzyme inhibition on renal haemodynamics protect renal function. Inhibitors of angiotensin converting enzyme should be considered for lowering blood pressure in patients with diabetic nephropathy.

Adult↗
PubMed1985

Thromboprophylactic effect of ticlopidine in arteriovenous fistulas for haemodialysis.

When constructing arteriovenous fistulas for haemodialysis in chronic renal failure patients, one of the main problems is still their clotting tendency. Ticlopidine is an effective inhibitor of platelet aggregation. In this randomized double-blind study placebo or ticlopidine 250 mg twice daily was given to chronic uremic patients up to 4 weeks after construction of an arteriovenous fistula. 42 patients were recruited and 36 completed the trial. The fistula clotted in 8 patients on placebo and in 2 patients on ticlopidine. The difference is significant. This effect was achieved without an increased frequency of side effects compared with placebo. It is concluded that ticlopidine has a function as a thromboprophylactic drug in chronic uremic patients.

Adult↗
PubMed1984

Captopril treatment of hypertension and renal failure in systemic lupus erythematosus.

Captopril, an angiotensin-converting enzyme inhibitor, was used to treat 14 patients with lupus nephritis and severe hypertension. All patients had reduced renal function and were on regular immunosuppressive therapy with corticosteroids and azathioprine. The initial dosage of captopril was reduced according to the level of renal impairment. 11 patients were treated for more than 6 months. Excellent blood pressure control was achieved with captopril, from a mean of 178 +/- 7/110 +/- 4 to 145 +/- 5/92 +/- 3 mm Hg at 6 months, usually in combination with a diuretic only. In 5 cases, a beta-blocker was added. In 3 patients, captopril therapy was discontinued within the 1st month of treatment. 1 patient did not respond to captopril at all; 1 patient had a rejection crisis and required dialysis; in 1 case, a general exanthema developed within 3 weeks and captopril medication was stopped. In addition to blood pressure control, renal function improved in 7 of the long-term-treated patients (mean increase in glomerular filtration rate 73 +/- 34%). In 3 patients, a continued slow deterioration renal function occurred, and in 1 patient, renal function remained unchanged. It is concluded that captopril is an effective antihypertensive drug in patients with systemic lupus erythematosus (SLE). Captopril treatment increased renal function in 64% of patients on long-term therapy. Not only optimal blood pressure control but other factors may also contribute to this beneficial effect, such as drug-induced prostaglandin release potentiating immunosuppressive treatment. Captopril may in fact be the drug of choice for the treatment of SLE patients with severe hypertension.

Adolescent↗
PubMed1984

Acute renal failure after intoxication with Cortinarius mushrooms.

Four previously healthy young adults developed the clinically recognised features of Cortinarius poisoning 3-4 days after intoxication. Two patients treated with haemoperfusion and haemodialysis 5 days after ingestion of the mushrooms regained normal kidney function. Two patients treated late with single haemoperfusion or dialysis had irreversible renal failure. The clinical results and our experimental studies on the toxic principle of the mushrooms indicate that early treatment with HP and HD may be important in order to avoid the development of irreversible renal failure.

Acute Kidney Injury↗
PubMed1982

Captopril treatment in hypertensive dialysis patients.

Captopril was used for treatment resistant arterial hypertension in 17 dialysis patients. Excellent blood-pressure control with diastolic blood-pressure less than 95 mmHg was obtained in 10 out of 17 patients (59%), with captopril as only drug in 8 patients. Six patients have been treated more than 6 months and 4 patients have been on the treatment for 1 year. The dosage of captopril could be kept low with maintained antihypertensive and angiotensin converting enzyme blocking effects. The acute blood-pressure lowering effect of captopril in dialysis patients was correlated to the initial plasma renin activity (p less than 0.001) but not long-term treatment, which was successful also in several low-renin patients. A few adverse reactions were encountered, e.g. urticaria and bullous exanthema, but all resolved when captopril treatment was stopped. Plasma potassium increased only from 4.8 +/- 0.1 to 5.0 +/- 0.1 mmol/l at the end of 1 month's treatment. Captopril appears to be a valuable drug for treatment of arterial hypertension in dialysis patients and offers an alternative to bilateral nephrectomy for the management of treatment resistant hypertension in these patients.

Blood Pressure↗