[Hemodynamic mechanisms of lupus nephritis progression].
OBJECTIVE
To study the role of abnormal intrarenal hemodynamics (IRHD) in progression of lupus nephritis (LN) and its response to therapy with inhibitors of angiotensin-converting enzyme (ACE).


METHODS
The trial included 30 LN patients (27 females, 3 males; age 29.8+(-)10.4 years). 19 had aggravation of active LN. All the patients were free of chronic renal insufficiency. IRHD was studied with estimation of renal functional reserve (RFR) using protein loading, evaluation of clinical activity of LN and renal function, blood pressure. The tests were repeated after 6 months of treatment with ACE inhibitors (captopril and ramiprilol) in 13 patients (11 of them had exacerbation of active LN).


RESULTS
Disturbed IRHD was found in 37% of the patients. Blood hypertension deteriorated this condition. Treatment with ACE inhibitors in 6 months brought about a significant decrease in blood pressure and improvement of IRHD. Before treatment RFR was absent in 46% of patients, after treatment in 1 patient.


CONCLUSIONS
Defects in IRHD occur in LN frequently. These are related with the presence of blood hypertension and activity of LN. Inhibitors of ACE seem perspective in management of essential hypertension in LN patients but this hypothesis needs confirmation by the results of further studies.
I E
IE
Tareeva
M Iu
MIu
Shvetsov
I M
IM
Kutyrina
O I
OI
Gerasimenko
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply*; D007677:Kidney Function Tests; D008181:Lupus Nephritis / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D017257:Ramipril / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D017257:Ramipril