Abstract | BACKGROUND/AIMS: METHODS: This study included 11 patients with type 2 DKD and an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m(2) who were suffering from severe edema even with loop diuretics. Each patient received additional hydrochlorothiazide ( HCTZ) therapy, which was continued for more than 12 months. We examined clinical parameters including blood pressure (BP), proteinuria, and eGFR before and after the addition of HCTZ. RESULTS: Patients received a 13.6 ± 3.8 mg/day dose of HCTZ in addition to loop diuretics ( azosemide: 120 mg/day in 6 cases, 60 mg/day in 3 cases and furosemide: 80 mg/day in 1 case, 120 mg/day in 1 case). Side effects of HCTZ were not observed in all patients. After the addition of HCTZ therapy, systolic and diastolic blood pressures (S-BP, D-BP) as well as proteinuria significantly decreased (S-BP: at 6 months, p < 0.05 and 12 months, p < 0.01 vs. 0 month, D-BP: at 12 months, p < 0.05 vs. 0 month, proteinuria: at 6 months, p < 0.05 and 12 months, p < 0.01 vs. 0 month). The annual decline in eGFR was not significantly different before and after HCTZ therapy (-7.7 ± 8.5 and -8.4 ± 4.8 mL/min/1.73 m(2)/year, respectively). CONCLUSION: Our findings suggest that the combination of HCTZ and loop diuretics improves BP levels, and decreases proteinuria even in advanced stage type 2 DKD patients with severe edema. The addition of HCTZ therapy was not found to negatively affect the change in eGFR in the present study.
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Authors | Taro Hoshino, Susumu Ookawara, Haruhisa Miyazawa, Kiyonori Ito, Yuichiro Ueda, Yoshio Kaku, Keiji Hirai, Honami Mori, Izumi Yoshida, Kaoru Tabei |
Journal | Clinical and experimental nephrology
(Clin Exp Nephrol)
Vol. 19
Issue 2
Pg. 247-53
(Apr 2015)
ISSN: 1437-7799 [Electronic] Japan |
PMID | 24821289
(Publication Type: Journal Article)
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Chemical References |
- Antihypertensive Agents
- Diuretics
- Renal Agents
- Sodium Potassium Chloride Symporter Inhibitors
- Sulfanilamides
- Hydrochlorothiazide
- Furosemide
- azosemide
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Topics |
- Aged
- Aged, 80 and over
- Antihypertensive Agents
(therapeutic use)
- Blood Pressure
- Diabetes Mellitus, Type 2
(complications)
- Diabetic Nephropathies
(complications, physiopathology)
- Diuretics
(therapeutic use)
- Drug Therapy, Combination
- Edema
(etiology)
- Female
- Furosemide
(therapeutic use)
- Glomerular Filtration Rate
- Humans
- Hydrochlorothiazide
(therapeutic use)
- Hypertension
(drug therapy, etiology)
- Male
- Middle Aged
- Proteinuria
(drug therapy, etiology)
- Renal Agents
(therapeutic use)
- Retrospective Studies
- Sodium Potassium Chloride Symporter Inhibitors
(therapeutic use)
- Sulfanilamides
(therapeutic use)
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