Update in Nephrology
- Stanley Goldfarb, MD; and
- William L. Henrich, MD
- 1998-99 Series; John Roberts, MD, Editor From University of Pennsylvania Hospital, Philadelphia, Pennsylvania; and Medical College of Ohio, Toledo, Ohio. Requests for Reprints: Stanley Goldfarb, MD, Department of Medicine, 100 Centrex, University of Pennsylvania Hospital, 3400 Spruce Street, Philadelphia, PA 19104; e-mail, sgoldfar@mail.med.upenn.edu. Current Author Addresses: Dr. Goldfarb: Department of Medicine, 100 Centrex, University of Pennsylvania Hospital, 3400 Spruce Street, Philadelphia, PA 19104.
Most clinically important advances in nephrology reported in 1997 occurred in four areas: hypertension and the role of simple treatment measures, delay of progression of end-stage renal disease in nondiabetic patients, screening for microalbuminuria, and effects of common hospital practices on electrolyte metabolism. Each article reviewed here was chosen by one of the authors and reviewed by the other. The importance of the study results to clinical practice and sound research methods were the major guides to study selection.
Hypertension
Many advances in the field of hypertension in 1997 focused on basic issues. Dietary measures were found to be effective for patients with mild hypertension. Thiazide diuretics were found to be safe and effective in diabetic and nondiabetic persons. Finally, a study of ambulatory blood pressure monitoring may change the way we study and measure blood pressure.
Diet Was Effective in the Treatment of Mild Hypertension
Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997; 336:1117-24.
Therapy for hypertension often centers on pharmacologic treatment, but attempts to decrease body weight, decrease intake of sodium and alcohol, and increase consumption of potassium and calcium are now receiving more attention [1]. The actual effectiveness of these dietary measures has not been known.
The DASH (Dietary Approaches to Stop Hypertension) trial tested whether some dietary measures altered blood pressure. All participants (459 healthy adults with mild hypertension) received a diet low in fruit, vegetables, and calcium for 3 weeks. They were then randomly assigned to receive one of three diets for 8 weeks: a controlled diet, which included one serving of fruit or vegetables and one serving of calcium; a diet high in fruits and vegetables, which contained 5 servings of fruit or vegetables; and a combination diet, which was high in …
This 100-word excerpt has been provided in the absence of an abstract.
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