Zdeněk Ramík, Martin Modrák, Tomáš Kvapil, Libor Jelínek, Martin Drápela, Zdeněk Lys, Bronislav Čapek, Dalibor Musil, Tomáš Veiser, Jan Václavík
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引用次数: 0
Abstract
Introduction: Alpha-blockers are considered an additional option when the major antihypertensive drug classes are insufficient in reducing blood pressure. While the impact of alpha-blockers on blood pressure control seems comparable, data evaluating their effects on renal outcomes are lacking. This systematic review and meta-analysis assess the impact on renal function from a medium to long-term perspective.
Methods: A search and analysis according to the PRISMA statement across Medline, the Web of Science, and ScienceDirect was conducted, covering articles in English on adult populations without time restrictions to December 14, 2023, including all types of studies with a minimum follow-up of 12 weeks.
Results: Seventeen studies were included in the review, encompassing a total of 26,170 patients treated with alpha-blockers. Most studies were performed in the 20th century and often lacked an adequate number of participants and sufficient follow-up duration. Bayesian meta-analysis showed neutral effects of alpha-blockers on eGFR and serum creatinine, comparable with those of other antihypertensive agents. Compared with baseline, the data suggests an overall small but clinically unimportant increase in creatinine clearance in patients treated with alpha-blockers (95% credible interval: 1.61 to 9.97 ml/min/1.73 m2).
Conclusion: A significant dearth of evidence concerning the long-term impact of alpha-blockers on renal function was revealed. The available evidence suggests that alpha-blockers have a neutral or non-inferior effect on renal function in comparison with other antihypertensive agents. Further research is needed to evaluate the role of alpha-blockers and their impact on preserving renal function.
期刊介绍：
This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.
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