the effectiveness hctz and acei edit

7/26/2019 The Effectiveness HCTZ and ACEI Edit

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The Effectiveness of HCTZ and ACEI/ARB versus ACEI/ARB Alone in

Decreasing Progression of Proteinuria in Hypertensive Chronic idney

Disease PatientsLAFORTEZA, MP; LISTANCO, OF; MONTEMAYOR, JA

I!TR"D#CTI"!

Chronic Kidney Disese re!ins "o #e one o$ "he !os" co!!on c%ses o$ !or"&i"y nd

!or#idi"y in "he Phi&i''ines( I" is "he co%n"ry)s * "h c%se o$ de"h( iA&!os" +- 'er !i&&ion.

'o'%&"ion re /e""in/ sic0 o$ 0idney $i&%re e1ery yer( A" "he end o$ 2-+, ro%nd 2,--- o$

"hese '"ien"s re on di&ysis "re"!en" nd "he n%!#ers re s"i&& incresin/ " +-.+34 'er yer(ii

5y'er"ension, on "he o"her hnd, is !on/ "he #i//es" sin/&e ris0 $c"ors $or de"hs 6or&d6ide( iii

The 7or&d 5e&"h Or/ni8"ion s""es "h" hy'er"ension c%ses * !i&&ion de"hs e1ery yer 6hi&e +(3

#i&&ion 'eo'&e s%$$er d%e "o i"s co!'&ic"ions( Accordin/ "o "he Phi&i''ine Socie"y o$ 5y'er"ension, 2+4

o$ Fi&i'ino d%&"s re hy'er"ensi1e(

Pro"ein%ri is ssoci"ed 6i"h "he onse" or 'ro/ression o$ 0idney disese(

"$%ectives

+9 To de"er!ine "he #ene$i"s o$ 5ydroch&or"hi8ide in co!#in"ion 6i"h ACE or AR: 1ers%sACE or AR: &one

29 To de"er!ine i$ "here is decrese in 'ro"ein%ri in '"ien"s %sin/ 5CTZs in co!#in"ion

6i"h ACE or AR:s

Pri&ary outco&es

'ethods

( Li"er"%re serch

A sys"e!"ic serch 6s done "o re"rie1e '%#&ished nd %n'%#&ished s"%dies in "re"e!en" o$

5CTZ 6i"h ACEAR:s( P%#!ed EM:ASE,ScienceDirec", /oo/&e scho&r nd Cochrne

Re/is"er o$ Con"ro&&ed Tri& d"#ses 6ere serched in d"es


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(

#( Se&ec"ion

The cri"eri %sed $or s"%dies "o #e inc&%ded in "his !e".n&ysis re s $o&&o6s?i( Rndo!i8ed con"ro&&ed "ri&s

ii( Po'%&"ions o$ '"ien"s di/nosed 6i"h s"/e .3 0idney $i&%re @FR o$

B-, :se&ine cre"inine +(2!/dL in !&es nd +(+!/dL in $e!&es9,

're di&ysisiii( The "re"!en" r! is &o6 or 1ery &o6 'ro"ein die" 6i"h 0e"o n&o/%e

s%''&e!en""ion nd "he con"ro& r! is &o6 'ro"ein die" &one(i1( The 'ri!ry o%"co!e !es%red 6s decrese in FR(

c( Assess!en" o$ Ris0 :is in Inc&%ded S"%dies

&idi"y nd %&i"y o$ ech s"%dy 6s ssess %sin/ "he


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Database search:

MEDLINE/Pubmed 54

Cochrane Library 32

EMB!E/!cience direct 2"

#oo$%e scho%ar

25 studies under&ent 'u%%(te)t re*ie&

++ studies o' ,C-s &ere inc%uded

+5 !tudies e)c%uded:

,easons inc%ude: seach o*er%a. no randomi0ation not ,C-

+4 studies e)c%uded

Based on a di1erent outcome .o.u%ation characteristics

Gsin/ "he PG:MED d"#se, 6e /"hered "o"& o$ 32 'o"en"i& r"ic&es nd "he o"her

$ore!en"ioned d"#ses yie&ded "o"& o$ +++ r"ic&es( The %"hors &so serched $or The

s%!!ry o$ "he serch s"r"e/y is i&&%s"r"ed in Fi/%re +(

(igure )* F&o6 di/r! o$ &i"er"%re serch nd se&ec"ion 'rocess(

For "he re1ie6 6e e1&%"ed "o"& o$ ++ s"%dies( These s"%dies e='&ici"&y !e" "he se"

inc&%sion cri"eri( The chrc"eris"ic o$ "he s"%dies re 'resen"ed in T#&e +(

A%"hor Yer Desi/n No o$ In"er1en"ion Pri!ry o%"co!e


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'"ien"s co!'r"or

Pr0sh 2--H RCT H LPDSLPD FR @DTPA9

Ser%! cre"inine

:MI

A%!in

Kh&r

or

Teshn

+H RCT LPDSLPD R"e o$ dec&ine

rne" 2-+ RCT LPDSLPD R"e o$ dec&ine

Te'&n 2--+ RCT FR

Cre"inine

A%!in

Mircesc% 2--* RCT LPDSLPD FR

M&1y + LPDSLP Gre

:r%nori 2--* RCT Di&ysis ini"i"ion

Fei"en 2--3 RCT Cre"inine

CrC&

A%!inDi Iorio 2-- RCT :GN

:ernhrd 2--+ Cre"inine

J%n/ers +* Cre

Cr C&

A##re1i"ions RCT rndo!i8ed con"ro& "ri&, LPD &o6 'ro"ein die", SLPD s%''&e!en"ed 1ery

&o6 'ro"ein die"

DI+C#++I"!

C"!C,#+I"!


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iDe%a Cru0 ,ose idney disease P6s "th %eadin$ cause o' death http://www.manilatimes.net/kidney-disease-phs-7th-leading-cause-of-death/77716/ 7eb 22 28+4

iiCrisos"o!o, Shei&( DO5? Cses o$ 0idney $i&%re on "he rise ( http://www.philstar.com/headlines/2014/02/25/1294271/doh-cases-kidney-failure-rise(Fe# 23, 2-+H

iii Philippine Society of Hypertension
http://www.manilatimes.net/kidney-disease-phs-7th-leading-cause-of-death/77716/http://www.manilatimes.net/kidney-disease-phs-7th-leading-cause-of-death/77716/http://www.philstar.com/headlines/2014/02/25/1294271/doh-cases-kidney-failure-risehttp://www.philstar.com/headlines/2014/02/25/1294271/doh-cases-kidney-failure-risehttp://www.manilatimes.net/kidney-disease-phs-7th-leading-cause-of-death/77716/http://www.manilatimes.net/kidney-disease-phs-7th-leading-cause-of-death/77716/

the effectiveness hctz and acei edit

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