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1º Oficina de Submissão de Artigos da Pará Research Medical Journal

Na oficina, os candidatos a submissão de artigos receberam informações de como evitar erros que tem sido comuns no momento da submissão desde falhas na redação do artigo, omissão de documentos obrigatórios, até a aprovação no comitê de ética, já que as pesquisas envolvem seres humanos”, esclareceu o Editor Chefe

http://www.santacasa.pa.gov.br/ensino/noticias/detalhe/?id=539

Pará Research Medical Journal
https://prmjournal.org/article/doi/10.4322/prmj.2019.038
Pará Research Medical Journal
Revisão Integrativa Clinica Médica

Tratamento hipertensivo nefroprotetor: medicamento de escolha para pacientes com nefropatia diabética

Nephroprotective hypertension treatment: drug of choice for patients with diabetic nephropathy

Caio Cardoso Coelho, Ana Clara Monteiro de Araújo, Isis Chaves Souza Alves, Taiane do Socorro Silva Natividade, Anderson Bentes de Lima

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Resumo

Objetivo: Revisar a literatura científica, considerando os prós e contras das terapias farmacológicas anti-hipertensivas e suas indicações para efeito nefroprotetor em pacientes nefropatas. Método: Trata-se de um estudo de revisão integrativa elaborada de acordo com os cinco passos da revisão integrativa, propostos por Whittemore. O PubMed e a Biblioteca Virtual em Saúde foram consultados nas bases de dados SciELO, Medline e Lilacs. Resultados: As principais escolhas são o Captopril, como representante da IECA e a Losartana, como representante do BRA. Ambas apresentam alterações no SRAA, e no caso da IECA também há alteração no sistema cinina-calicreína. Esse mecanismo de ação leva aos efeitos adversos relatados na literatura, sendo a grande maioria considerado bem toleráveis. Considerações finais: Não há consenso na literatura quanto a melhor escolha entre as classes, entretanto os efeitos adversos podem ser considerados na escolha do fármaco e de acordo com a situação clínica apresentada.

Palavras-chave

nefropatias; inibidores da enzima conversora de angiotensina; bloqueadores do receptor tipo 1 de angiotensina II; hipertensão.

Abstract

Purpose: To review the scientific literature, considering the pros and cons of pharmacological antihypertensives therapies and their indications for nephroprotective effect in nephropathic patients. Methods: This is an integrative review of literature elaborated according to the five phases of the integrative review, proposed by Whittemore; the PubMed and the Health Virtual Library were consulted using the databases SciELO, Medline and Lilacs. Results: The main choices are Captopril as ACEI representative and Losartana as ARB representative. Both have alterations in the RAAS, and in the case of ACEI there is also alteration in the kinin-kallikrein system. This mechanism of action leads to adverse effects reported in the literature, and the vast majority are considered well tolerable. Conclusion: There is no consensus in the literature regarding the best choice between medication classes, however adverse effects can be considered in the choice of drug and according to the clinical situation presented.

Keywords

kidney diseases; angiotensin-converting enzyme inhibitors; angiotensin II type 1 receptor blockers; hypertension.

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Submetido em:
16/12/2019

Aceito em:
26/05/2020

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