title: Initial effect of enalapril on kidney function in patients with moderate to severe chronic nephropathy.
abstract: Angiotensin converting enzyme (ACE) inhibitors has been suggested to halt the progression of chronic renal failure. As the initial step of a controlled trial of this hypothesis, it was investigated whether start of enalapril in patients with severe chronic nephropathy might cause a critical fall in their renal function. Thirty-one patients were studied, 26 on chronic antihypertensive treatment with drugs other than ACE inhibitors and 5 untreated normotensive. 51Cr-EDTA plasma clearance and renal technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scintigraphy were made before and 24 h after start of enalapril, mean dose 9 mg. Blood pressure fell from median 148/88 to 119/78 mmHg (p less than 0.01). Glomerular filtration rate (GFR) fell from median 14 to 12 ml/min/1.73 m2 (p less than 0.01). The median change in GFR was -14% (range -44% to +10%). The split renal function was unchanged and the scintigrams showed no intrarenal activity defects. In conclusion, enalapril caused a fall in GFR, which was clinically acceptable in most of the patients.
authors.affiliation: Department of Nephrology, Herlev Hospital University of Copenhagen, Denmark.
authors.forename: A L
authors.initials: AL
authors.lastname: Kamper
authors.forename: H S
authors.initials: HS
authors.lastname: Thomsen
authors.forename: S L
authors.initials: SL
authors.lastname: Nielsen
authors.forename: S
authors.initials: S
authors.lastname: Strandgaard
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy*; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000188:drug therapy*; D004113:Succimer
chemical_list: D004656:Enalapril; D004113:Succimer