Effect of 1-year treatment with nitrendipine versus enalapril on urinary albumin and alpha 1-microglobulin excretion in microalbuminuric patients with type 1 diabetes mellitus. A randomized, single-blind comparative study.
In order to compare the long-term effects of nitrendipine (CAS 39562-70-4) and enalapril (CAS 75847-73-3) on variables of glomerular and tubular function in type 1 diabetes mellitus, a single-blind, randomised comparative 1-year study was carried out in microalbuminuric patients (6 women, 14 men, age, 30-58 years, duration of diabetes, 3-41 years, HbA1 sigma 5.5-10%). 10 patients were treated with 20 mg/d nitrendipine, 10 patients were treated with 10 mg/d enalapril. On the average, urinary albumin excretion was decreased by 38 +/- 4% by nitrendipine (p < 0.01 vs. before treatment) and by 21 +/- 8% by enalapril (p < 0.05 vs. before treatment). The excretion of alpha 1-microglobulin decreased by 35 +/- 10% and by 39 +/- 9%, respectively (p < 0.05 vs. before treatment). Creatine clearance rose by 20 +/- 30% during nitrendipine treatment (p < 0.05 vs. before treatment) but was unchanged during enalapril treatment. Total kidney volume decreased by 23 +/- 4% (p < 0.01) and by 14 +/- 6% (p < 0.05), respectively. Blood pressure fell by 8 +/- 1% systolic and by 13 +/- 1% (diastolic) in nitrendipine-treated patients (both p < 0.01) and by 10 +/- 1% and 13 +/- 1% in enalapril-treated patients (both p < 0.01). Thus, nitrendipine long-term treatment of microalbuminuric type 1 diabetic appeared to be as effective as the treatment with enalapril in preventing or postponing the progression of diabetic nephropathy.
Jungmann
E
E
Abteilung für Endokrinologie, Johann Wolfgang Goethe-Universität, Frankfurt/Main, Fed. Rep. of Germany.
Malanyn
M
M
Mortasawi
N
N
Unterstöger
E
E
Haak
T
T
Palitzsch
K D
KD
Scherberich
J
J
Schumm-Draeger
P M
PM
Usadel
K H
KH
D000328:Adult; D000419:Albuminuria / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D000510:Alpha-Globulins / Q000652:urine*; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000517:prevention & control; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000627:therapeutic use*; D012083:Renin / Q000097:blood; D016037:Single-Blind Method
D000510:Alpha-Globulins; C016001:alpha-1-microglobulin; D004656:Enalapril; D009568:Nitrendipine; D003404:Creatinine; D012083:Renin