Sildenafil improves renal function in patients with pulmonary arterial hypertension

British Journal of Clinical Pharmacology
David J WebbJulie O Maurey

Abstract

Elevated serum creatinine (sCr) and low estimated glomerular filtration rate (eGFR) are associated with poor outcomes in patients with pulmonary arterial hypertension (PAH) whereas sildenafil treatment improves PAH outcomes. This post hoc analysis assessed the effect of sildenafil on kidney function and links with clinical outcomes including 6-min walk distance, functional class, time to clinical worsening and survival. Patients with PAH received placebo or sildenafil 20, 40 or 80 mg three times daily in the SUPER-1 study and open-label sildenafil titrated to 80 mg three times daily (as tolerated) in the extension study. Baseline characteristics were similar among groups (n = 277). PAH was mostly idiopathic (63%) and functional class II (39%) or III (58%). From baseline to week 12, kidney function improved (increased eGFR, decreased sCr) with sildenafil and worsened with placebo. In univariate logistic regression, improved kidney function was associated with significantly improved exercise and functional class (odds ratios 1.17 [95% CI 1.01, 1.36] and 1.21 [95% CI 1.03, 1.41], respectively, for sCr and 0.97 [95% CI 0.94, 0.99] and 0.97 [95% CI 0.94, 0.99] for eGFR, all P < 0.05). In patients who maintained or improved kidney fu...Continue Reading

References

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Citations

Feb 23, 2018·American Journal of Nephrology·Laurent BitkerLaurent Juillard
Feb 23, 2018·American Journal of Nephrology·Amir Kazory, Edward A Ross
Feb 25, 2020·Circulation·Stephan RosenkranzMarius M Hoeper
Jul 14, 2020·Current Opinion in Nephrology and Hypertension·Daniel L Edmonston, Matthew A Sparks
May 7, 2020·JMIR Public Health and Surveillance·Moshe RogosnitzkyAlejandro R Jadad

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