Different effects between antihypertensive drugs on nephrotic-range proteinuria in renovascular hypertension.
A 61-year-old man developed renovascular hypertension characterized by nephrotic-range proteinuria. When he was treated with a calcium channel blocker, glomerular filtration fraction was 0.26 and massive proteinuria ranging from 10 to 15 g/day persisted. An angiotensin-converting enzyme inhibitor markedly reduced the proteinuria to 1-2 g/day with a filtration fraction of 0.20. After the antihypertensive drug was switched to a beta-blocker, the filtration fraction was 0.23 and urinary protein excretion was 3-4 g/day. Blood pressure control was comparable by each drug. These findings suggest a role of intraglomerular hydraulic mechanism in the etiology of massive proteinuria in renovascular hypertension.
Ishimitsu
T
T
Department of Medicine, Dokkyo University School of Medicine, Tochigi, Japan.
Yagi
H
H
Ohkubo
M
M
Nakamura
Y
Y
Yagi
S
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017298:Bisoprolol / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004656:Enalapril / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D011507:Proteinuria / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004656:Enalapril; D009543:Nifedipine; D017298:Bisoprolol