title: [Comparison of ARB and ACEI for renoprotection in chronic glomerulonephritis].
abstract: This 1.5-year prospective study compared the effects of angiotensin II receptor blocker, candesartan(n = 21), and ACE inhibitor(ACEI, n = 23) on proteinuria and renal function in patients with moderate renal impairment due to chronic glomerulonephritis. Blood pressure reductions were comparable between both groups. Proteinuria was significantly reduced from 2.1 +/- 0.4 (mean +/- SE) to 0.6 +/- 0.2 g/day(p < 0.001) with candesartan, and the reduction was significantly larger than with ACEI(p < 0.01). Serum creatinine did not increase with candesartan or ACEI, suggesting the renoprotective effect. Serum potassium increased significantly with both drugs from 6 months. Plasma aldosterone concentrations(PAC) showed a stronger suppression with candesartan(150 pg/ml before treatment and 51 at 1.5 years) than with ACEI(104 pg/ml at 1.5 years). Plasma renin activity with candesartan(1.0 ng/ml/hr before treatment) decreased from 3.9 ng/ml/hr at 6 months to 1.3 at 1.5 years, whereas PRA remained elevated with ACEI. We speculate that the stronger reduction of PAC contributed to suppression of growth of mesangial matrix and the interstitial fibrosis in the candesartan group.
authors.affiliation: Department of Internal Medicine, Keio University School of Medicine.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kumagai
authors.forename: Katsufumi
authors.initials: K
authors.lastname: Sakata
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Matsuura
authors.forename: Masaki
authors.initials: M
authors.lastname: Imai
authors.forename: Toshiko
authors.initials: T
authors.lastname: Onami
authors.forename: Kamon
authors.initials: K
authors.lastname: Iigaya
authors.forename: Takao
authors.initials: T
authors.lastname: Saruta
mesh_terms: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002908:Chronic Disease; D005921:Glomerulonephritis / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D011446:Prospective Studies; D013777:Tetrazoles / Q000627:therapeutic use*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan