Academic Journal
Effectiveness of thiazide and thiazide-like diuretics in advanced chronic kidney disease: a systematic review and meta-analysis
| العنوان: | Effectiveness of thiazide and thiazide-like diuretics in advanced chronic kidney disease: a systematic review and meta-analysis |
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| المؤلفون: | Flávio Teles, Jorge Artur Peçanha de Miranda Coelho, Rosivânia Maria Albino, Fernanda Cristina Verçosa Pacheco, Evilly Rodrigues de Oliveira, Marcelo Augusto Duarte Silveira, Audes Diógenes M. Feitosa, Rodrigo Bezerra |
| المصدر: | Renal Failure, Vol 45, Iss 1 (2023) |
| بيانات النشر: | Taylor & Francis Group, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Diseases of the genitourinary system. Urology |
| مصطلحات موضوعية: | Chronic kidney disease, hypertension, diuretics, thiazides, Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | Background and objective Thiazide diuretics are first-line drugs for the treatment of hypertension, but hypertension treatment guidelines have systematically discouraged their use in patients with advanced chronic kidney disease (CKD). For the first time, a systematic review and random-effects meta-analysis were performed to assess the effectiveness of thiazides and thiazide-like diuretics to treat hypertension in patients with stages 3b, 4, and 5 CKD.Design, setting, participants, & measurements A systematic review and random-effects meta-analysis that included a literature search using the following databases were performed: MEDLINE through PubMed, Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) through the Cochrane Library, Embase, and ISI – Web of Science (all databases). Prospective studies that evaluated the effectiveness of thiazide and thiazide-like diuretics in individuals with a GFR < 45 mL/min/1.73 m2 were included.Results Five clinical trials, totaling 214 participants, were included, and the mean GFR ranged from 13.0 ± 5.9 mL/min/1.73 m2 to 26.8 ± 8.8 mL/min/1.73 m2. There was evidence of a reduction in mean blood pressure and in GFR, as well as in fractional sodium excretion and fractional chloride excretion.Conclusion Thiazide and thiazide-like diuretics seem to maintain their effectiveness in lowering blood pressure in patients with advanced chronic kidney disease. These findings should spur new prospective randomized trials and spark discussions, particularly about upcoming hypertension guidelines. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 0886022X 1525-6049 0886-022X |
| Relation: | https://doaj.org/toc/0886-022X; https://doaj.org/toc/1525-6049 |
| DOI: | 10.1080/0886022X.2022.2163903 |
| URL الوصول: | https://doaj.org/article/aa6c60930b64465186234ab70d38530a |
| رقم الانضمام: | edsdoj.6c60930b64465186234ab70d38530a |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 0886022X 15256049 |
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| DOI: | 10.1080/0886022X.2022.2163903 |