Effect of captopril on blood pressure and kidney function in normotensive insulin dependent diabetics with nephropathy.
OBJECTIVE
To assess whether inhibition of angiotensin converting enzyme protects kidney function in diabetic nephropathy.


METHODS
Open, randomised follow up study of normotensive insulin dependent diabetics with nephropathy either treated or not with captopril for one year.


METHODS
Outpatient diabetic clinic in a tertiary referral centre.


METHODS
32 Normotensive patients with insulin dependent diabetes complicated by nephropathy who were randomised either to the treatment group (n = 15) or to the control group (n = 17).


METHODS
The treatment group was given captopril (25-100 mg/day) for 12 months, the average dose during the second six months of the study being 40 mg daily. Controls were not treated.


METHODS
Albuminuria, arterial blood pressure, and the glomerular filtration rate.


RESULTS
Mean arterial blood pressure fell by 3 (SE 2) mm Hg in the captopril treated group and rose by 6 (1) mm Hg in the controls. In addition, albuminuria declined by 11% in the captopril treated group and rose by 55% in the controls, fractional albumin clearance fell by 17% in the captopril treated group and increased by 66% in the controls, and the glomerular filtration rate declined by 3.1 (2.8)ml/min/1.73 m2 with captopril and by 6.4 (3.1) ml/min/1.73 m2 in the controls.


CONCLUSIONS
Inhibition of angiotensin converting enzyme arrests the progressive rise in albuminuria in normotensive insulin dependent diabetics with nephropathy.
Parving
H H
HH
Hvidöre Hospital, Klampenborg, Denmark.
Hommel
E
E
Damkjaer Nielsen
M
M
Giese
J
J
D000328:Adult; D000419:Albuminuria / Q000503:physiopathology; D000553:Ambulatory Care; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000494:pharmacology* / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects; D013997:Time Factors
D002216:Captopril