Effect of angiotensin-converting enzyme inhibition on nephropathy in patients with a remnant kidney.
OBJECTIVE
This study was performed to evaluate the effect of angiotensin-converting enzyme inhibitor (ACEI) therapy and dietary protein restriction on nephropathy involving a remnant kidney.


METHODS
Five patients with proteinuria > or = 5 years following partial removal of a solitary kidney were treated with a low-protein diet and an ACEI agent. Four patients had biopsy-proven focal segmental glomerulosclerosis. The daily urinary protein excretion ranged from 1240 to 10,032 mg. The serum creatinine levels ranged from 1.2 to 3.1 mg/dL.


RESULTS
The post-treatment follow-up interval ranged from 18 to 30 months. The treatment regimen was well tolerated in all patients. Four patients experienced a reduction in the urinary protein level while maintaining stable overall renal function. In 1 patient, the urinary protein level increased and renal function gradually deteriorated following ACEI therapy.


CONCLUSIONS
These preliminary data suggest that ACEI therapy and a low-protein diet may mitigate nephropathy associated with a remnant kidney.
Novick
A C
AC
Department of Urology, Cleveland Clinic Foundation, OH 44195, USA.
Schreiber
M J
MJ
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018753:Diet, Protein-Restricted; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005923:Glomerulosclerosis, Focal Segmental / Q000178:diet therapy / Q000188:drug therapy; D006801:Humans; D007674:Kidney Diseases / Q000178:diet therapy / Q000188:drug therapy*; D017706:Lisinopril / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011507:Proteinuria / Q000178:diet therapy / Q000188:drug therapy
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D017706:Lisinopril