title: Comparative study of enalapril vs. losartan on residual renal function preservation in automated peritoneal dialysis. A randomized controlled study.
abstract: BACKGROUND
  Residual renal function (RRF) is an important determinant of mortality and morbidity in patients receiving peritoneal dialysis (PD). Recent studies have shown a positive effect of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) on RRF in PD patients.
  
  
  OBJECTIVE
  To compare enalapril and losartan for RRF preservation in automated peritoneal dialysis (APD) patients.
  
  
  METHODS
  An open label randomized controlled trial (RCT) with a 12 month follow-up period was conducted to compare the effect of enalapril vs. losartan on RRF preservation in 60 APD patients. Measurements were done at the start of the study (baseline), 3, 6, 9, and 12 months. A historical control group (HCG) without treatment was included to assess the natural history of RRF loss.
  
  
  RESULTS
  RRF in the enalapril group dropped from 3.65 +/- 1.6 (baseline) to 2.36 +/- 0.38 mL/min/1.73 m2 (12 months). In the losartan group RRF was reduced from 4.1+/- 2.01 (baseline) to 2.54 +/- 0.47 mL/min/ 1.73 m2 (12 months). There were not significant differences between the two groups regarding RRF at 12 months. In the HCG, RRF declined from 3.68 +/- 0.48 to 1.4 +/- 0.29 mL/min/ 1.73 m2 (12 months). RRF in the HCG was significantly lower than RRF in the two treated groups at 12 months (P < 0.05).
  
  
  CONCLUSIONS
  There was not significant difference on RRF preservation between enalapril and losartan groups. Comparing these results to those of the HCG suggests that the treatment with any of the drugs is useful in preserving RRF.
authors.affiliation: Hospital de Concentración, Instituto de Seguridad Social del Estado de México y Municipios (ISSEMYM) de Satélite, Naucalpan. artmar@prodigy.net.mx
authors.forename: Fernando Arturo
authors.initials: FA
authors.lastname: Reyes-Marín
authors.forename: Claudia
authors.initials: C
authors.lastname: Calzada
authors.forename: Araceli
authors.initials: A
authors.lastname: Ballesteros
authors.forename: Dante
authors.initials: D
authors.lastname: Amato
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood / Q000652:urine; D018450:Disease Progression; D004656:Enalapril / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy; D019808:Losartan / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects*; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods; D011446:Prospective Studies; D014508:Urea / Q000097:blood / Q000652:urine; D055815:Young Adult
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D004656:Enalapril; D014508:Urea; D003404:Creatinine; D019808:Losartan