Short term effect of captopril on microalbuminuria induced by exercise in normotensive diabetics.
OBJECTIVE
To investigate whether captopril has any effect on microalbuminuria induced by exercise in normotensive diabetic patients with early stage nephropathy.


METHODS
Randomised, double blind, crossover trial.


METHODS
Outpatient department.


METHODS
22 diabetics with stage II nephropathy (urinary albumin excretion rate less than 20 micrograms/min; 15 with type I diabetes and seven with type II), 32 patients with stage III nephropathy (urinary albumin excretion rate 20-200 micrograms/min; 14 with type I diabetes and 18 with type II), and 10 normal subjects.


METHODS
Four exercise tests on a cycle ergometer: the first two under basal conditions and the third and fourth after subjects had received captopril (two 25 mg doses in 24 hours) or placebo (two tablets in 24 hours).


METHODS
Exercised until 90% of maximum heart rate achieved.


RESULTS
Mean urinary excretion one hour after the first two exercise tests was 21 micrograms/min in normal subjects, 101 micrograms/min in diabetic patients with stage II nephropathy, and 333 micrograms/min in those with stage III nephropathy. Similar results were obtained after placebo. After captopril the urinary excretion rate one hour after exercise was significantly decreased in diabetics with stage II (36 micrograms/min) and stage III (107 micrograms/min) disease compared with placebo but not in normal subjects. Systolic and diastolic pressures were similar in the three groups after placebo and captopril had been given.


CONCLUSIONS
Captopril significantly reduces microalbuminuria induced by exercise in normotensive diabetics without affecting systemic blood pressure. Captopril may reduce renal intracapillary pressure.
Romanelli
G
G
Cattedra di Patologia Speciale Medica, University of Brescia, Italy.
Giustina
A
A
Cimino
A
A
Valentini
U
U
Agabiti-Rosei
E
E
Muiesan
G
G
Giustina
G
G
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000188:drug therapy* / Q000503:physiopathology; D001794:Blood Pressure; D002216:Captopril / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000652:urine*; D004311:Double-Blind Method; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D013997:Time Factors
D002216:Captopril