Tolerability and efficacy of benazepril in cats with chronic kidney disease.
The objective of the study was to test the effect of the angiotensin-converting enzyme inhibitor (ACEI) benazepril in cats with chronic kidney disease (CKD). A total of 192 cats with CKD with an initial plasma creatinine concentration > or = 2 mg/dL (> or = 177 micromol/L) and urine specific gravity < or = 1.025 were recruited into a double-blind, parallel-group, prospective, randomized clinical trial. Cats received daily (q24h) PO placebo (n = 96) or benazepril x HCl at a dosage of 0.5-1.0 mg/kg (n = 96) for up to 1,119 days. Most cats were fed exclusively a diet containing low amounts of phosphate, protein, and sodium. Benazepril produced a significant reduction in proteinuria, assessed by the urine protein-to-creatinine ratio (UPC, P = .005). This effect of benazepril was present in all subgroups tested, including cats with UPC <0.2, although the effect was largest in cats with higher UPCs. Plasma protein was maintained at higher concentrations with benazepril as compared with placebo during treatment in cats with initial UPC <1 (P = .038 versus P = .079 for all cats). There was no difference in renal survival time between the 2 groups when all 192 cats were compared. Mean +/- SD renal survival times were 637 +/- 480 days with benazepril and 520 +/- 323 days with placebo (P = .47). Mean +/- SD renal survival times in the 13 cats with initial UPC > or = 1 were 402 +/- 202 days with benazepril and 149 +/- 90 days with placebo (P = .27). Cats with initial UPC > or = 1 treated with benazepril had better appetite (P = .017) as compared with those treated with placebo. Benazepril was well tolerated. In conclusion, benazepril decreased proteinuria in cats with CKD.
King
Jonathan N
JN
Novartis Animal Health Inc, Postfach, Basel, Switzerland. jonathan.king@novartis.com
Gunn-Moore
Danielle A
DA
Tasker
Séverine
S
Gleadhill
Allison
A
Strehlau
Günther
G
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D019540:Area Under Curve; D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D001772:Blood Cell Count / Q000662:veterinary; D001774:Blood Chemical Analysis / Q000662:veterinary; D001798:Blood Proteins / Q000378:metabolism; D002371:Cat Diseases / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D002415:Cats; D003404:Creatinine / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy* / Q000652:urine / Q000662:veterinary*; D008297:Male; D011446:Prospective Studies; D011507:Proteinuria / Q000097:blood / Q000188:drug therapy / Q000652:urine / Q000662:veterinary*; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D001798:Blood Proteins; D003404:Creatinine; C044946:benazepril