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PRIMER HIPERTANSIYONDA TRANDOLAPRIL VE LOSARTAN TEDAVISININ GLOMERÜLO-TUBÜLER FONKSIYONLARA ETKISI

THE EFFECTS OF TRANDOLAPRİL AND LOSARTAN ON GLOMERULO-TUBULER FUNCTION IN PRIMARY HYPERTENSION

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Abstract (2. Language): 
İn primary hypertension (HT), organs are damaged by vascular disturbance. The kidney is a major end organ in HT. In antihypertensive theraphy; beside the aim of lowering the blood pressure, use of preparations with organ protective properties is also important. In our study, markers of glomerulo-tubuler function were investigated in 63 HT patients with mean blood pressure (SBP) 158.9± 11.4 mmHg, diyastolic blood pressure (DBP) 99.7 ±6.9 mmHg and compared to 41 healthy individuals. In HT group, the effects of six months trandolapril and losartan theraphy on renal functions were evaluated. In patients group, uric acid (ÜA), proteinuria, urinary albumin excretion (UAE), urinary N-acetyl fi-u glucozaminidase (NAG) and Beta-2-microglobulin $2m) excretion were significantly higher than the control group's. There were a positive linear correlation between UAE and body mass index (BMI), proteinuria, GFR; urinary NAG excretion and SBP, DBP, fi2m excretion and SBP. With a two week salt limited diet, levels of SBP, DBP and Na' were significantly decreased Trandolapril theraphy lead to a significant decrease in proteinuria, UAE, urinary NAG excreation. UA, proteinuria, UAE, urinary NAG and fi2m excretions were seen to be significantly decreased with losartan treatment. Our results show, in patient groups significant glomerulo-tubuler dysfunction were found at early stage. Antihypertensive and renoprotective effects of trandolapril and losartan were found similar.
Abstract (Original Language): 
Primer Hipertansiyon (HT) sonucu organlar vasküler hasarla bozulur ve böbrek önemli hedef organdır. Tedavide, kan basıncı (KB) düşürülmesi yanında, organ koruyucu ilaçların kullanılması da önemlidir. Çalışmamızda, ortalama sistolik kan basıncı (SKB) 158.9 ±11.4 mmHg, diyastolik kan basıncı (DKB) 99.7 ±6.9 mmHg olan 63 HT'lu ile 41 sağlıklıda glomerülo-tubüler fonksiyon göstergeleri araştırılarak, hastalarda altı aylık trandolapril ve losartan tedavisinin renal fonksiyonlara etkisi incelendi. HT'lularda kontrole göre ürik asid (ÜA), proteinüri, üriner albumin atılımı (ÜAE), idrarla N-asetil fi-u glukozaminidaz (NAG) ve Beta-2-mikroglobülin 02m) atılımında anlamlı artışla belirgin glomerülo-tubüler etkilenme saptandı. ÜAE ile DKB, vücut kitle indeksi (VKİ), proteinüri, GFR; üriner NAG atılımı ile SKB, DKB; fi2m atılımı ile SKB pozitif doğrusal ilişkili bulundu. Hastalarda iki hafta tuz kısıtlı diyetle SKB, DKB, Na anlamlı düştü. SKB ve DKB deki anlamlı düşmenin yanısıra trandolapril tedavisi ile proteinüri, ÜAE, üriner NAG atılımı, losartan tedavisi ile ÜA, proteinüri, ÜAE, üriner NAG ve P2m atılımı anlamlı azaldı. Bulgularımız, hastalarımızda erken evrede belirgin glomerülo-tubüler etkilenme oluştuğunu, trandolapril ve losartanın antihipertansifve renoprotektif etkilerinin benzer olduğunu göstermiştir.
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