Nebivolol Improves Renal Function in Patients Who Underwent Angioplasty due to Renal Artery Stenosis: A Pilot Study

Duranay, Murat; Kanbay, Mehmet; Akay, Hatice; Unverdi, Selman; Sürer, Hatice; Altay, Mustafa; Kırbaş, İsmail; Covic, Adrian; Zoccali, Carmine

doi:10.1159/000262304

Cited by 26 publications

(12 citation statements)

References 34 publications

(21 reference statements)

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“…CIN is the third leading cause of hospital-acquired acute renal failure (7). In a previous study, nebivolol has improved renal function in patients who underwent angioplasty due to renal artery stenosis (8). An experimental study in rats has also shown preventive effect of nebivolol on contrast-induced nephropathy previously (9).…”

Section: Introductionmentioning

confidence: 98%

The role of nebivolol in the prevention of contrast-induced nephropathy in patients with renal dysfunction

Avcı¹,

Yeşìl²,

Bayata³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Bu prospektif çalışma renal disfonksiyonlu olgularda koroner anjiyografiyi takiben kontrast nefropati gelişimi üzerine nebivolol'ün potansiyel koruyucu etkisini metoprolol ile karşılaştırmak amacı ile gerçekleştirilmiştir. Yöntemler: Kreatinin seviyeleri 1.2 mg/dl ve üzerinde olan stabil koroner anjina pektoris'li 90 olgu bu prospektif çalışmaya alındı. Hastalar 2 gruba ayrıldı. Birinci gruptaki 55 olgu koroner arter hastalığı ve/veya hipertansiyon endikasyonu ile 5 mg/gün dozda oral nebivolol aldı. İkinci gruptaki 35 olgu ise benzer endikasyonlarla 50 mg/gün dozda metoprolol aldı. Renal koruma amacı ile hastalar %0.9 NaCl ile (1 mL/kg/saat) işlem önce-si 12 saat ve işlem sonrası 24 saat hidrate edildiler. Hastalara ayrıca işlemden 24 saat önce başlamak ve işlem sonrası 48 saat devam etmek üzere 600 mg N-acetylcysteine (NAC) günde 2 doz halinde verildi. Hastalar daha sonra rutin koroner anjiyografiye alındılar. Serum kreatinini işlemden hemen önce, işlemden sonra ve 48. saatte ölçüldü. Kontrast nefropatisi işlemden sonraki 48 saat içerisinde serum kreatinin değerinde bazal ölçüme göre %25 ve daha fazla artış olarak tanımlandı. Çalışma sonunda gruplar arasında sürekli değişkenlerin karşılaştırması için bağım-sız örneklem t-testi, kategorik verilerin karşılaştırılmasında ise Ki-kare testi kullanıldı. Bulgular: Anjiyografi öncesi her iki grupta da serum kreatinin seviyeleri benzerdi. Anjiyografi sonrası serum kreatinin seviyeleri her iki grupta da artış gösterdi. Anjiyografi sonrası kreatinin seviyeleri bakımından nebivolol ve metoprolol grupları arasında istatistik olarak anlamlı bir fark yoktu. ABSTRACTObjective: This prospective study was designed to evaluate the potential protective effect of nebivolol compared with metoprolol on the development of contrast-induced nephropathy (CIN) following coronary angiography in patients with renal dysfunction. Methods: Ninety patients with stable coronary angina pectoris with renal insufficiency (creatinine value ≥ 1.2 mg/dl) were included for this prospective study. Patients were divided into two groups. Patients in group 1 (n=55) received oral administration of nebivolol 5 mg/daily for coronary artery disease and/or hypertension. Group 2 consisted of 35 patients who received metoprolol 50 mg/daily for the same indications. All patients were hydrated with 0.9% NaCl at a rate of 1 mL/kg/hr for 12 hours before and 24 hours after the procedure. Patients were also given N-acetylcysteine (NAC) 600 mg twice a day, beginning 24 hours before and continuing 48 hours after the procedure. All patients underwent routine coronary angiography. Serum creatinine was assessed just before, immediately after and 48 hours after the procedure. CIN was defined as an increase in serum creatinine concentration of ≥25% within 48 hours after the procedure compared to the patient's baseline value. Tests for significance between groups were conducted using the independent sample t-test for continuous variables and Chi-square test for categorical variables. Results: Baseline serum creatinin...

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Section: Introductionmentioning

confidence: 98%

The role of nebivolol in the prevention of contrast-induced nephropathy in patients with renal dysfunction

Avcı¹,

Yeşìl²,

Bayata³

et al. 2011

Anadolu Kardiyol Derg

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“…20 In a pilot study of 33 patients with severe renal artery stenosis who underwent revascularization, nebivolol ( n =17) significantly increased estimated glomerular filtration rate and decreased proteinuria as compared with the control group. 30 Nebivolol was also found to be effective in nephrotoxicity induced by contrast media. 31 In patients pre-treated with nebivolol before coronary angiography and ventriculography, it was found that nebivolol did not increase serum creatinine.…”

Section: Oxidative Damage To the Kidney: A Role For Nebivololmentioning

confidence: 99%

Protective effects of nebivolol from oxidative stress to prevent hypertension-related target organ damage

Coats

Jain²

2017

J Hum Hypertens

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Hypertension is one of the leading risk factors for morbidity and mortality in patients with cardiovascular and cerebrovascular diseases and renal impairment. It also leads to target organ damage (TOD), which worsens organ function and the patient's clinical status. Reactive oxygen species (ROS)-mediated oxidative stress may contribute significantly to TOD in patients with hypertension. NO (nitric oxide) is a paracrine factor derived from endothelial cells that has been shown to alleviate ROS-mediated oxidative damage. Nebivolol is a third-generation β-blocker with vasodilator activity, both actions contributing to decreased blood pressure in hypertensive patients. Its vasodilatory function is mediated by the endothelial l-arginine NO pathway. Nebivolol increases the bioavailability of NO in the vasculature. Its efficacy and safety profile is comparable to other commonly used antihypertensive agents. In this article, we review the current literature to understand TOD secondary to oxidative stress in patients with hypertension and the role of nebivolol in its prevention. A better understanding of the underlying mechanisms by which nebivolol reduces ROS-mediated TOD will not only help in the development of targeted therapies but may also improve health outcomes in hypertensive patients.

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“…По данным, полученным в небольшом исследо-вании, включавшем 33 пациента с реноваскулярной АГ, назначение небиволола в течение 6 месяцев по-сле операции реваскуляризации почечных артерий не влияет на выделение нитритов/нитратов с мо-чой по сравнению с контрольной группой больных, но способствует достоверному снижению протеи-нурии и повышает уровень СКФ с исходных 44,8 до 50,6 мл/мин/1,73 м 2 [13].…”

Section: клиническая эффективность небиволола у больных хронической бunclassified

“…Оба пре-парата оказывают выраженный антиоксидантный эффект и защищают почки от повреждения в экс-периментах на крысах с различными моделями гипертонической и диабетической нефропатии. Ряд данных свидетельствует о том, что небиволол и в большей степени карведилол могут препятство-вать потере альбуминов с мочой у больных гипер-тонической и диабетической нефропатиями [8,13,14,23], однако их способность замедлять прогрес-сирование ХБП у таких пациентов нуждается в кли-ническом подтверждении.…”

Section: заключениеunclassified

Beta-adrenoblockers of third generation as medicines for drug therapy of patients with chronic kidney disease

Кузьмин

Викторович

Belyanin

et al. 2016

Rev Clin Pharm Drug Ther

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Ключевые слова:хроническая болезнь почек; β-адреноблокаторы; карведи-лол; небиволол. РезюмеВ обзоре обсуждаются результаты доклинических и кли-нических исследований, посвященных выявлению нефро-протекторного действия β-адреноблокаторов 3-го поколе- ния карведилола и небиволола на моделях гипертонической и диабетической нефропатий и больных хронической болез-нью почек. Сделано заключение, что небиволол и особенно карведилол, отличающиеся от своих предшественников до-полнительными антиоксидантными и нефропротекторны-ми свойствами, могут быть препаратами выбора из группы β-адреноблокаторов для лекарственной терапии гипертен-зивных пациентов с хронической болезнью почек. BETA-ADRENOBLOCKERS OF THIRD GENERATION AS MEDICINES FOR DRUG THERAPY OF PATIENTS WITH CHRONIC KIDNEY DISEASE Keywords: chronic kidney disease; β-blockers; carvedilol; nebivolol. Abstract. The review discusses the results of preclinical and clinical trials on the identification of nephroprotective action of β-blockers 3 generation carvedilol and nebivolol on models of hypertensive and diabetic nephropathy and patients with chronic kidney disease. It was concluded that nebivolol and especially carvedilol differs from its predecessors additional antioxidant and nephroprotective properties may be the drugs of choice from β-blockers for drug therapy of hypertensive patients with chronic kidney disease. ВВЕДЕНИЕСовременные рекомендации по диагности-ке и лечению гипертензивных больных с хрони-ческой болезнью почек (ХБП) рассматривают β-адреноблокаторы как лекарственные средства третьей линии, которые добавляются к ингибиторам ренин-ангиотензиновой системы (РАС), диуретикам и/или блокаторам Са 2+ -каналов для дополнительно-го контроля целевых уровней АД [4,20,32]. Это ка-сается прежде всего атенолола, метопролола, бисо-пролола и других селективных β 1 -адреноблокаторов 2-го поколения, антигипертензивный эффект которых связан преимущественно с кардиодепрессивным действием и резким снижением сердечного выбро-са, повышающим риск нарушения кровоснабжения и функции почек. Благодаря своему антигипертен-зивному эффекту препараты этого ряда обладают также нефропротекторным действием, но по сво-ей способности замедлять прогрессирование ХБП существенно уступают ингибиторам ангиотен-зин-превращающего фермента (иАПФ) и блокато-рам АТ 1 -ангиотензиновых рецепторов (БРА) [9,18].В последнее время в клинической практике ши-рокое распространение получили липофильные β-адреноблокаторы 3-го поколения, которые отлича-ются от своих предшественников дополнительными благоприятными фармакологическими свойствами. Наибольший интерес среди них представляют кар-ведилол и небиволол, которые не только улучшают кровоснабжение почек [17], но и препятствуют раз-витию в клубочках, проксимальных канальцах (ПК) и других структурах почечной ткани оксидативного стресса и связанного с ним воспалительного и фи-

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Nebivolol Improves Renal Function in Patients Who Underwent Angioplasty due to Renal Artery Stenosis: A Pilot Study

Cited by 26 publications

References 34 publications

The role of nebivolol in the prevention of contrast-induced nephropathy in patients with renal dysfunction

The role of nebivolol in the prevention of contrast-induced nephropathy in patients with renal dysfunction

Protective effects of nebivolol from oxidative stress to prevent hypertension-related target organ damage

Beta-adrenoblockers of third generation as medicines for drug therapy of patients with chronic kidney disease

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