The successful use of phosphodiesterase type 5 inhibitors to treat the syndrome of cor pulmonale and prerenal azotemia with diuresis of anasarca (CorPRADA).

Abstract

BACKGROUND:

The occurrence of deteriorating renal function test results along with the attempts at diuresis of anasarca has been described but not named, and no solution other than the standard treatment of related medical conditions such as congestive heart failure (CHF) and reducing or stopping diuretics has been offered. Phosphodiesterase type 5 inhibitors (PD5I) are known to reduce pulmonary hypertension (PH). The PD5Is sildenafil and, just recently, tadalafil, have FDA indications in primary pulmonary hypertension (PPH).

METHODS:

In this observational study of CorPRADA patients treated with PD5I, 12 out of 19 cases met criteria for inclusion in statistical analysis. Medication reductions/discontinuations generally were made. Pre- and post-treatment data were analyzed using matched pairs.

RESULTS:

There were significant improvements in edema, glomerular filtration rate (GFR), weight, and loop diuretic dosage required, while strong trends were seen in urine output per day and urine output per unit loop diuretic per day.

CONCLUSION:

The identification of CorPRADA and the use of standard treatments for PH plus PD5I medication show promise in achieving successful diuresis of anasarca while stabilizing or improving renal function simultaneously.

• Authors: Paul Bruce Berez
• Journal: Southern medical journal (South Med J) Vol. 103 Issue 2 Pg. 116-20 (Feb 2010) ISSN: 1541-8243 [Electronic] United States
• PMID: 20065909 (Publication Type: Journal Article)

Chemical References

• Carbolines
• Diuretics
• Phosphodiesterase Inhibitors
• Piperazines
• Purines
• Sulfones
• Tadalafil
• Sildenafil Citrate

Topics

• Azotemia (drug therapy)
• Blood Pressure (drug effects)
• Carbolines (administration & dosage, therapeutic use)
• Diuresis (drug effects)
• Diuretics (adverse effects, therapeutic use)
• Edema (drug therapy)
• Glomerular Filtration Rate (drug effects)
• Humans
• Hypertension, Pulmonary (drug therapy)
• Phosphodiesterase Inhibitors (administration & dosage, therapeutic use)
• Piperazines (administration & dosage, therapeutic use)
• Pulmonary Heart Disease (chemically induced, drug therapy)
• Purines (administration & dosage, therapeutic use)
• Sildenafil Citrate
• Sulfones (administration & dosage, therapeutic use)
• Tadalafil