Angiotensin II receptor antagonists versus angiotensin converting enzyme inhibitors: effects on renal function.
OBJECTIVE
Recent work has suggested that proximal tubular reabsorption of sodium may be regulated by a local renin-angiotensin system which may be independent of the circulating renin-angiotensin system. The aim of this review was to examine the long-term renal consequences of blockade of the renin-angiotensin system by angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists.


RESULTS
Except in states of extreme volume depletion, in which ACE inhibitors may, unlike angiotensin II receptor antagonists, have an adverse effect on the glomerular filtration rate, no differences were observed between the two types of inhibitor. Like ACE inhibitors, the angiotensin II inhibitors TCV 116 and losartan cause a marked impairment in the renal adaptation to dietary sodium restriction, suggesting that blockade of the renin-angiotensin system is primarily involved in this process.


CONCLUSIONS
Further studies in human renovascular hypertension and chronic renal disease are required.
Jover
B
B
Department of Medicine, Centre Hospitalier Universitaire, Montpellier, France.
Mimran
A
A
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000378:metabolism*; D000818:Animals; D001562:Benzimidazoles / Q000494:pharmacology; D001713:Biphenyl Compounds / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D007093:Imidazoles / Q000494:pharmacology; D007668:Kidney / Q000378:metabolism*; D019808:Losartan; D011945:Receptors, Angiotensin / Q000378:metabolism; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013777:Tetrazoles / Q000494:pharmacology
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D007093:Imidazoles; D011945:Receptors, Angiotensin; D013777:Tetrazoles; D019808:Losartan; C077793:candesartan cilexetil