Skip to main content
NCBI home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1986 Aug 23;293(6545):471–474. doi: 10.1136/bmj.293.6545.471

Beneficial effects of angiotensin converting enzyme inhibition on renal function in patients with diabetic nephropathy.

S Björck, G Nyberg, H Mulec, G Granerus, H Herlitz, M Aurell
PMCID: PMC1341108  PMID: 3017501

Abstract

The effects of angiotensin converting enzyme inhibition with captopril were investigated in patients with diabetic nephropathy and hypertension. After nine days' treatment with captopril glomerular filtration rate was unchanged in 13 patients, whereas renal plasma flow had increased from 265 to 302 ml/min/1.73 m2 body surface area (p less than 0.05) and the filtration fraction had decreased from 14.3 to 12.8% (p less than 0.025). During two years' treatment with captopril in 14 patients the mean arterial blood pressure had fallen by 5 mm Hg (p less than 0.005) and the deterioration in glomerular filtration rate had decreased from 10.3 to 2.4 ml/min/year (p less than 0.005). There was no correlation between the fall in blood pressure and the reduction in the deterioration of glomerular filtration rate. These findings suggest that the effects of angiotensin converting enzyme inhibition on renal haemodynamics protect renal function. Inhibitors of angiotensin converting enzyme should be considered for lowering blood pressure in patients with diabetic nephropathy.

Full text

PDF
471

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson S., Meyer T. W., Rennke H. G., Brenner B. M. Control of glomerular hypertension limits glomerular injury in rats with reduced renal mass. J Clin Invest. 1985 Aug;76(2):612–619. doi: 10.1172/JCI112013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Björck S., Delin K., Herlitz H., Larsson O., Aurell M. Renin secretion in advanced diabetic nephropathy. Scand J Urol Nephrol Suppl. 1984;79:53–57. [PubMed] [Google Scholar]
  3. Blantz R. C., Konnen K. S., Tucker B. J. Angiotensin II effects upon the glomerular microcirculation and ultrafiltration coefficient of the rat. J Clin Invest. 1976 Feb;57(2):419–434. doi: 10.1172/JCI108293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Christlieb A. R., Kaldany A., D'Elia J. A. Plasma renin activity and hypertension in diabetes mellitus. Diabetes. 1976 Oct;25(10):969–974. doi: 10.2337/diab.25.10.969. [DOI] [PubMed] [Google Scholar]
  5. Hall J. E., Guyton A. C., Jackson T. E., Coleman T. G., Lohmeier T. E., Trippodo N. C. Control of glomerular filtration rate by renin-angiotensin system. Am J Physiol. 1977 Nov;233(5):F366–F372. doi: 10.1152/ajprenal.1977.233.5.F366. [DOI] [PubMed] [Google Scholar]
  6. Hostetter T. H., Rennke H. G., Brenner B. M. The case for intrarenal hypertension in the initiation and progression of diabetic and other glomerulopathies. Am J Med. 1982 Mar;72(3):375–380. doi: 10.1016/0002-9343(82)90490-9. [DOI] [PubMed] [Google Scholar]
  7. Mogensen C. E. Glomerular filtration rate and renal plasma flow in short-term and long-term juvenile diabetes mellitus. Scand J Clin Lab Invest. 1971 Sep;28(1):91–100. doi: 10.3109/00365517109090667. [DOI] [PubMed] [Google Scholar]
  8. Mogensen C. E. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J (Clin Res Ed) 1982 Sep 11;285(6343):685–688. doi: 10.1136/bmj.285.6343.685. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Puska P., Iacono J. M., Nissinen A., Korhonen H. J., Vartianinen E., Pietinen P., Dougherty R., Leino U., Mutanen M., Moisio S. Controlled, randomised trial of the effect of dietary fat on blood pressure. Lancet. 1983 Jan 1;1(8314-5):1–5. doi: 10.1016/s0140-6736(83)91556-8. [DOI] [PubMed] [Google Scholar]
  10. Taguma Y., Kitamoto Y., Futaki G., Ueda H., Monma H., Ishizaki M., Takahashi H., Sekino H., Sasaki Y. Effect of captopril on heavy proteinuria in azotemic diabetics. N Engl J Med. 1985 Dec 26;313(26):1617–1620. doi: 10.1056/NEJM198512263132601. [DOI] [PubMed] [Google Scholar]
  11. Weidmann P., Beretta-Piccoli C., Keusch G., Glück Z., Mujagic M., Grimm M., Meier A., Ziegler W. H. Sodium-volume factor, cardiovascular reactivity and hypotensive mechanism of diuretic therapy in mild hypertension associated with diabetes mellitus. Am J Med. 1979 Nov;67(5):779–784. doi: 10.1016/0002-9343(79)90734-4. [DOI] [PubMed] [Google Scholar]
  12. Wiseman M. J., Drury P. L., Keen H., Viberti G. C. Plasma renin activity in insulin-dependent diabetics with raised glomerular filtration rate. Clin Endocrinol (Oxf) 1984 Oct;21(4):409–414. doi: 10.1111/j.1365-2265.1984.tb03228.x. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES