[Antiproteinuric effect of renin-angiotensin system blockade in patients with normal/lower than 115 mmHg systolic blood pressure].
The renoprotective effect of renin-angiotensin system (RAAS) blockade by ACE inhibitors (ACEI) or AT1 receptor antagonists (ARA) in chronic proteinuric nephropathies is well known. Most studies have related this beneficial effect with the antihypertensive and antiproteinuric properties of these drugs, but this aspect has not been extensively analyzed in patients with normal/low values of blood pressure. We studied nineteen patients with different chronic proteinuric nephropathies that started ACEI or ARA because of proteinuria and despite systolic blood pressure (SBP) < or = 115 mmHg. Short and long-term tolerance to treatment as well as evolution of renal function parameters were recorded.


RESULTS
At baseline, SBP was 110.2 +/- 2.6 mmHg (105-115) an diastolic blood pressure (DBP) 68.6 +/- 4.3 (60-75). Initial low doses of ACEI or ARA were well tolerated. After 6 months of treatment, proteinuria decreased by 46% of baseline, from 2.1 +/- 1.8 g/day to 1.1 +/- 0.8 g/day, without significant changes in BP or renal function. After a 48 +/- 27 months follow up, proteinuria decreased to 0.7 +/- 0.6 g/day (68% of basal values). Renal function and BP did not show significant changes during follow up.


CONCLUSIONS
RAAS blockade by ACEI/ARA induces a significant antiproteinuric and renoprotective effect in proteinuric patients with normal/low levels of BP Initial doses of ACEI/ARA were well tolerated.
Gutiérrez
E
E
Servicio de Nefrología, Hospital 12 de Octubre, Madrid. eduardogm90@hotmail.com
González
E
E
Morales
E
E
Herrero
J C
JC
Manzanera
M J
MJ
García
J A
JA
Domínguez-Gil
B
B
Hernández
E
E
Praga
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology; D012084:Renin-Angiotensin System / Q000502:physiology; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents