José Luiz Santello

Three cases of hypertension and Renal Arteriovenous fistula with a de novo fistula

Fistula Arteriovenosa Renal (FAVR) e uma causa rara e potencialmente reversivel de hipertensao e insuficiencia renal e/ou cardiaca. O tratamento da FAVR visa preservar o maximo de parenquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serao relatados tres casos de FAVR, incluindo um caso de FAVR idiopatica de novo, que se apresentaram com hipertensao e insuficiencia renal e/ou cardiaca, e descrever a terapeutica adotada e os resultados obtidos.The Renal Arteriovenous Fistula (RAVF) is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

Captopril associado à hidroclorotiazida no tratamento da hipertensão leve e moderada. Estudo multicêntrico brasileiro

PURPOSE: To evaluate the effectiveness and tolerance of the association of captopril 50mg and hydrochlorithiazide 25mg in hypertensive patients with diastolic pressure between 95 and 115 mmHg. METHODS: An open, multicenter and non-comparative study was performed. After 2 weeks of placebo, the patients received ½ tablet of drug association. Patients were evaluated after 4, 8 and 12 weeks, and those who had diastolic pressure >90mmHg after 8 weeks of therapy received 1 tablet/day. RESULTS: The results of 433 patients were analyzed: 47±10 years old, 30% female, 76% white. Initial systolic and diastolic pressures were 156±16 and 103±11mmHg and after 14 days of placebo were 156±15 and 103±9mmHg (p>0.05). Systolic/diastolic pressure after 4, 8 and 12 weeks of treatment reduced progressively (p<0.05) to 143±14/95±11, 140±13/91±9 and 134±11/86±8mmHg. Blood pressure control was observed in 45, 67 and 88% (p<0.05) of patients after 4, 8 and 12 weeks. Cough was the most important symptom, registered in 7% of patients under placebo and 12% in patients under treatment. The tolerance was considered good for 98% of patients. CONCLUSION: The association of captopril with hydrochlorothiazide is effective with good tolerance, being indicated as a once a day monotherapy for mild and moderate hypertension.PURPOSE: To evaluate the effectiveness and tolerance of the association of captopril 50mg and hydrochlorithiazide 25mg in hypertensive patients with diastolic pressure between 95 and 115 mmHg. METHODS: An open, multicenter and non-comparative study was performed. After 2 weeks of placebo, the patients received ½ tablet of drug association. Patients were evaluated after 4, 8 and 12 weeks, and those who had diastolic pressure >90mmHg after 8 weeks of therapy received 1 tablet/day. RESULTS: The results of 433 patients were analyzed: 47±10 years old, 30% female, 76% white. Initial systolic and diastolic pressures were 156±16 and 103±11mmHg and after 14 days of placebo were 156±15 and 103±9mmHg (p>0.05). Systolic/diastolic pressure after 4, 8 and 12 weeks of treatment reduced progressively (p<0.05) to 143±14/95±11, 140±13/91±9 and 134±11/86±8mmHg. Blood pressure control was observed in 45, 67 and 88% (p<0.05) of patients after 4, 8 and 12 weeks. Cough was the most important symptom, registered in 7% of patients under placebo and 12% in patients under treatment. The tolerance was considered good for 98% of patients. CONCLUSION: The association of captopril with hydrochlorothiazide is effective with good tolerance, being indicated as a once a day monotherapy for mild and moderate hypertension.

Três casos de hipertensão e Fístula Arteriovenosa Renal: com uma fístula de novo

Fistula Arteriovenosa Renal (FAVR) e uma causa rara e potencialmente reversivel de hipertensao e insuficiencia renal e/ou cardiaca. O tratamento da FAVR visa preservar o maximo de parenquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serao relatados tres casos de FAVR, incluindo um caso de FAVR idiopatica de novo, que se apresentaram com hipertensao e insuficiencia renal e/ou cardiaca, e descrever a terapeutica adotada e os resultados obtidos.The Renal Arteriovenous Fistula (RAVF) is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

Tres casos de hipertención y Fístula Arteriovenosa Renal: con una fístula de novo

Fistula Arteriovenosa Renal (FAVR) e uma causa rara e potencialmente reversivel de hipertensao e insuficiencia renal e/ou cardiaca. O tratamento da FAVR visa preservar o maximo de parenquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serao relatados tres casos de FAVR, incluindo um caso de FAVR idiopatica de novo, que se apresentaram com hipertensao e insuficiencia renal e/ou cardiaca, e descrever a terapeutica adotada e os resultados obtidos.The Renal Arteriovenous Fistula (RAVF) is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.