title: Clearance of imidapril, an Angiotensin-converting enzyme inhibitor, during hemodialysis in hypertensive renal failure patients: comparison with quinapril and enalapril.
abstract: The dialyzability of imidaprilat, an active metabolite of the angiotensin-converting enzyme (ACE) inhibitor imidapril, was determined and compared with those of enalaprilat and quinaprilat in hypertensive patients on chronic hemodialysis. Imidapril (5 mg/d, n = 6), enalapril (2.5 mg/d, n = 6), or quinapril (2.5 mg/d, n = 6) was given for at least 8 weeks prior to the trial. During dialysis, enalaprilat, but not imidaprilat or quinaprilat, concentrations in both sides decreased significantly. Compared to enalaprilat, the dialyzabilities of imidaprilat and quinaprilat were significantly lower (dialyzer clearance [mL/min/m(2)]: enalaprilat, 41.8 +/- 7.4; imidaprilat, 19.0 +/- 7.8; quinaprilat, 8.9 +/- 1.3). The dialyzabilities of the 3 drugs were negatively correlated with their respective protein-binding rates. During hemodialysis, blood pressure did not change significantly in any group. These results suggest that imidapril provides good blood pressure control without a large fluctuation of drug concentration in hypertensive patients undergoing chronic hemodialysis.
authors.affiliation: Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical School, 3311 Yakushiji, Minamikawachi, Tochigi 329-0498, Japan. tsuru@jichi.ac.jp.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tsuruoka
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitoh
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Koh-ichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Tokie
authors.initials: T
authors.lastname: Hayasaka
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Saito
authors.forename: Akio
authors.initials: A
authors.lastname: Fujimura
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004656:Enalapril / Q000097:blood / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D048289:Imidazolidines / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008297:Male; D000077583:Quinapril; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D044005:Tetrahydroisoquinolines / Q000097:blood / Q000493:pharmacokinetics
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D048289:Imidazolidines; D044005:Tetrahydroisoquinolines; D004656:Enalapril; C065166:imidapril; D000077583:Quinapril