Efeito do uso de carvedilol no sistema nervoso simpático de pacientes submetidos à hemodiálise / Effect of Carvedilol in the Sympathetic Nervous Sistem on dialisys pacients.

AUTOR(ES)

João Isuk Suh

DATA DE PUBLICAÇÃO

2008

RESUMO

Hemodialysis patients with chronic renal insufficiency always show evidence of hyperactivity of the Sympathetic Nervous System that causes cardiovascular alterations and consequently greater mortality. With the use of Carvedilol in patients with Congestive Heart Failure, improvement in its morbi-mortality was evidenced, that was also verified with the population of hemodialysis patients. The correlation of its clinical effect with the levels of Norepinephrine during hemodialysis, absent in other publications, was the objective of the present study. We prospectively studied 26 stable patients on hemodialysis three times a week during 14 days, all of them used Placebo for 7 days and Carvedilol for 7 more days in increasing doses, reaching a maximum of 18, 75mg /day at the end of the study (day 14). At day 0 and day 14 were measured Norepinephrine plasma levels before and after hemodialysis, patients answered the same questionary regarding symptoms before, during and after hemodialysis at day 0 , 7 and 14, the occurrence of arrhythmias during hemodialysis were recorded by Holter at day 0 and day 14. All patients completed the study. With Placebo, pre and post dialysis Norepinephrine was 253,50pg/ml and 336,50pg/ml (p=0,01), and with Carvedilol, was 350,00pg/ml and 333,50pg/ml (p=0,81) respectively. There were less ventricular arrhythmias with the use of Carvedilol (17,50 x 1,50 , p=0,02). Hemodialysis increased Norepinephrine levels during Placebo whereas with Carvedilol, Norepinephrine plasma levels remained constant without changing tolerance during hemodialisys procedure.

ASSUNTO(S)

questionnaires child development disorders pervasive/diagnosis questionários transtornos globais do desenvolvimento infantil/diagnóstico transtorno autístico autistic disorder validation studies estudos de validação

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