Deterioration of renal function during angiotensin converting enzyme inhibition in hypertensive patients with a poorly functioning solitary kidney.
During treatment with the angiotensin converting enzyme inhibitor, Captopril, glomerular filtration rate (GFR) decreased in three unilaterally nephrectomized hypertensive patients with a poorly functioning remaining kidney. The fall in GFR was not related to changes in the blood pressure, and was reversed when Captopril was stopped. In a fourth nephrectomized patient the initially normal GFR was not affected by captopril. These observations point to a functional reduction in GFR due to a withdrawal of an intrarenal action of angiotensin II. Maintenance of GFR may become critically dependent on a functioning renin-angiotensin system when renal perfusion pressure is reduced to a certain degree. Inhibition of angiotensin II formation may lead to a decrease in GFR in patients with renal hypertension and pre-existing renal insufficiency.
Rasmussen
S
S
Ibsen
H
H
Giese
J
J
D000368:Aged; D000804:Angiotensin II / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006977:Hypertension, Renal / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011392:Proline / Q000031:analogs & derivatives*; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D000804:Angiotensin II; D011392:Proline; D002216:Captopril; D012083:Renin