title: Recoverability of renal function after relief of chronic partial unilateral ureteric obstruction: The effect of an angiotensin-converting enzyme inhibitor (enalapril).
abstract: OBJECTIVE
  We evaluated the effect of an angiotensin-converting enzyme inhibitor (enalapril) on renal function during and after the relief of partial unilateral ureteric obstruction (UUO).
  
  
  METHODS
  Thirty-two male mongrel dogs were classified into three groups: sham (eight), control (12; left partial UUO + no medication) and study (12; left partial UUO + enalapril). Dogs in the study and control groups were subjected to 4 weeks of partial UUO. After that, the dogs were re-opened and subjected to Lich-Gregoir vesico-ureteric re-implantation, and were killed humanely by the end of the eighth week after relief of obstruction. The study and control groups were evaluated at baseline, after 4 weeks of obstruction and at 4 and 8 weeks after relief of obstruction, by measuring selective creatinine clearance (CCr), selective renographic clearance (RCr) and renal resistive index (RI). The sham group had sham surgery at 4 and 8 weeks and was evaluated as the other two groups.
  
  
  RESULTS
  Sham surgery showed no significant effect on any of the evaluated variables. Compared with the control, enalapril offset the reductions of CCr and RCr by an extra 11% and 12% of the basal values by the end of the fourth week of obstruction, respectively. Moreover, compared with the control, enalapril enhanced the recovery of CCr by an extra 10% and of RCr by an extra 23% of the basal values at 8 weeks after relief of the 4-week obstruction. In addition, the increase in RI was significantly less in the enalapril group.
  
  
  CONCLUSIONS
  Enalapril decreases the deterioration of renal function in partial UUO and enhances the recoverability of renal function after relief of obstruction.
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Shady A
authors.initials: SA
authors.lastname: Soliman
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosbah
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abol-Enein
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Nashwa
authors.initials: N
authors.lastname: Barakat
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Essam
authors.initials: E
authors.lastname: Abou-Bieh
authors.affiliation: Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ehab W
authors.initials: EW
authors.lastname: Wafa
keywords: (U)UO, (unilateral) ureteric obstruction; ACE, angiotensin-converting enzyme; CCr, creatinine clearance; DUS, Doppler ultrasonography; Enalapril; RAS, renin-angiotensin system; RCr, renographic clearance; RI, resistive index; Recoverability of renal function; Ureteric obstruction