Comparison between the Effects of Indapamide and Hydrochlorothiazide on Creatinine Clearance in Patients with Impaired Renal Function and Hypertension

Madkour, Hosameldin; Gadallah, Merit F.; Riveline, B; Plante, Gérard E.; Massry, Shaul G.

doi:10.1159/000168841

Cited by 22 publications

(8 citation statements)

References 17 publications

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“…Indapamide, however, is a thiazide-like sulfonamide and has been shown to be metabolically neutral in a wide range of patients including diabetic ones [11, 27, 28]. In this study, metabolic neutrality of indapamide is reflected in the improvement of total cholesterol, fasting glucose, and triglyceride levels that were obtained without any changes of other concomitant treatment with lipid lowering agents, or with antidiabetics.…”

Section: Discussionmentioning

confidence: 70%

Efficacy and Tolerability of Fixed-Dose Combination of Perindopril/Indapamide in Type 2 Diabetes Mellitus: PICASSO Trial

Farsang

2014

Adv Ther

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BackgroundHypertension and type 2 diabetes mellitus (T2DM) synergistically deteriorate the vascular environment, making blood pressure reduction challenging, and substantially increasing cardiovascular risk.MethodsIn the real-life, open-label, observational, PICASSO study, 9,257 hypertensive patients unsuccessfully treated with antihypertensives were switched to fixed-dose combination of perindopril 10 mg/indapamide 2.5 mg. In this subgroup analysis, we analyzed changes in blood pressure and laboratory parameters of 2,762 hypertensive patients with T2DM or pre-diabetes.ResultsAfter 3 months of treatment, significant decreases in office blood pressure were noted in the whole cohort (−27.0 ± 14.8/−12.7 ± 9.8 mmHg; p < 0.001). Significant decreases were also recorded in patients with grade 1 hypertension (19.2 ± 10.0/−9.4 ± 7.9 mmHg), grade 2 (29.2 ± 10.9/−13.3 ± 8.7 mmHg) and grade 3 (−45.1 ± 15.4/−21.5 ± 11.2 mmHg). Significant decreases in ambulatory blood pressure were also noted (n = 93). In patients previously treated with angiotensin-converting enzyme inhibitor ± hydrochlorothiazide or angiotensin receptor blocker ± hydrochlorothiazide, mean 24-h blood pressure decreased by 23.4 ± 13.9/11.5 ± 9.7 and 22.3 ± 8.7/10.4 ± 13.2 mmHg, respectively (p < 0.001). Treatment was well tolerated and the switch to treatment with perindopril/indapamide was associated with improvements in laboratory parameters.ConclusionsData from this diabetes subgroup analysis suggest that fixed combination of perindopril 10 mg/indapamide 2.5 mg should be routinely considered for the treatment of hypertension in diabetic patients who are unsuccessfully managed with other antihypertensive medications.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-014-0107-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 70%

Efficacy and Tolerability of Fixed-Dose Combination of Perindopril/Indapamide in Type 2 Diabetes Mellitus: PICASSO Trial

Farsang

2014

Adv Ther

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“…There were no significant changes in glucose metabolic control, blood levels of cholesterol, triglyceride, low or high density lipoproteins or the plasma concentration of electrolytes or uric acid. Renal function was not affected adversely as evidenced by a significant change in the plasma concentration of creatinine or in creatinine clearance; this is not surprising since long-term therapy with indapamide has been reported to be associated with improvement in renal function [16].…”

Section: Discussionmentioning

confidence: 68%

Efficacious Response with Low-Dose Indapamide Therapy in the Treatment of Type II Diabetic Patients with Normal Renal Function or Moderate Renal Insufficiency and Moderate Hypertension

et al. 2002

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We examined the efficacy of low daily dose (1.25 mg/day) of indapamide in the treatment of high blood pressure in patients with diabetes mellitus with normal renal function and those with moderate renal insufficiency (serum creatinine <1.5 mg/dl). The study was an open label one of four months duration. Twenty-eight patients were enrolled in the study and only 15 completed it. Within 2 weeks of therapy, systolic blood pressure fell from 173 ± 4.5 to 144 ± 2.0 mm Hg and diastolic blood pressure from 96 ± 2.1 to 80 ± 1.8 mm Hg (p < 0.01) and blood pressure remained at these levels throughout the study. The results show that low dose indapamide is effective in the treatment of moderate hypertension in patients with diabetes mellitus who have normal renal function or moderate renal insufficiency. Therefore, this dose of 1.25 mg/day is recommended for the treatment of such patients.

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“…To achieve adequate diuresis, infusions of loop diuretics have been demonstrated to have greater efficacy than intermittent dosing [8], and certainly loop diuretics are preferred to thiazides, whose actions are diminished in patients with impaired kidney function [9]. In a recent study, ADHF patients who developed hemoconcentration during diuresis (presumed to be diuresed in excess of refilling rate) did in fact have a greater risk of worsening renal function with an odds ratio of 5.3 ( P < .001), however they also had lower 180-day mortality, with a hazard ratio of 0.31 ( P = .013) [10].…”

Section: Management Of Acute Cardiorenal Syndrome (Type 1)mentioning

confidence: 99%

Pharmacological Management of Cardiorenal Syndromes

House

Haapio

Lassus

et al. 2011

International Journal of Nephrology

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Cardiorenal syndromes are disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The pharmacological management of Cardiorenal syndromes may be complicated by unanticipated or unintended effects of agents targeting one organ on the other. Hence, a thorough understanding of the pathophysiology of these disorders is paramount. The treatment of cardiovascular diseases and risk factors may affect renal function and modify the progression of renal injury. Likewise, management of renal disease and associated complications can influence heart function or influence cardiovascular risk. In this paper, an overview of pharmacological management of acute and chronic Cardiorenal Syndromes is presented, and the need for high-quality future studies in this field is highlighted.

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Comparison between the Effects of Indapamide and Hydrochlorothiazide on Creatinine Clearance in Patients with Impaired Renal Function and Hypertension

Cited by 22 publications

References 17 publications

Efficacy and Tolerability of Fixed-Dose Combination of Perindopril/Indapamide in Type 2 Diabetes Mellitus: PICASSO Trial

Efficacy and Tolerability of Fixed-Dose Combination of Perindopril/Indapamide in Type 2 Diabetes Mellitus: PICASSO Trial

Efficacious Response with Low-Dose Indapamide Therapy in the Treatment of Type II Diabetic Patients with Normal Renal Function or Moderate Renal Insufficiency and Moderate Hypertension

Pharmacological Management of Cardiorenal Syndromes

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