title: Captopril to mitigate chronic renal failure after hematopoietic stem cell transplantation: a randomized controlled trial.
abstract: OBJECTIVE
  To test whether the angiotensin-converting enzyme inhibitor captopril was effective in mitigating chronic renal failure after hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  A total of 55 subjects undergoing total body irradiation (TBI)-HSCT were enrolled in this randomized controlled trial. Captopril or identical placebo was started at engraftment and continued as tolerated until 1 year after HSCT.
  
  
  RESULTS
  The baseline serum creatinine and calculated glomerular filtration rate (GFR) did not differ between groups. The 1-year serum creatinine level was lower and the GFR higher in the captopril compared with the placebo group (p = 0.07 for GFR). Patient survival was higher in the captopril compared with the placebo group, but this was also not statistically significant (p = 0.09). In study subjects who received the study drug for more than 2 months, the 1-year calculated GFRs were 92 mL/min and 80 mL/min, for the captopril and placebo groups, respectively (p = 0.1). There was no adverse effect on hematologic outcome.
  
  
  CONCLUSIONS
  There is a trend in favor of captopril in mitigation of chronic renal failure after radiation-based HSCT.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ecohen@mcw.edu
authors.forename: Eric P
authors.initials: EP
authors.lastname: Cohen
authors.forename: Amy A
authors.initials: AA
authors.lastname: Irving
authors.forename: William R
authors.initials: WR
authors.lastname: Drobyski
authors.forename: John P
authors.initials: JP
authors.lastname: Klein
authors.forename: Jakob
authors.initials: J
authors.lastname: Passweg
authors.forename: Julie-An M
authors.initials: JA
authors.lastname: Talano
authors.forename: Mark B
authors.initials: MB
authors.lastname: Juckett
authors.forename: John E
authors.initials: JE
authors.lastname: Moulder
mesh_terms: D000293:Adolescent; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D002648:Child; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014916:Whole-Body Irradiation / Q000009:adverse effects*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D003404:Creatinine