Effect of ramipril on blood pressure and protein excretion rate in normotensive nondiabetic patients with proteinuria

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
R D TotoR D Smith

Abstract

Angiotensin-converting enzyme inhibitors reduce proteinuria in both normotensive and hypertensive patients with proteinuric renal disease. However, the mechanism of the antiproteinuric effect has not been clarified. We performed a prospective, double-blind, placebo-controlled, randomized crossover trial to test the hypothesis that the antiproteinuric effect of ramipril was due to an improvement in glomerular permselectivity independent of blood pressure and glomerular filtration rate. The effect of low-dose (1.25 mg/d) and high-dose (5 mg/d) ramipril was assessed in 15 normotensive nondiabetic patients with proteinuria (> 150 mg/d). The study was divided into four 12-week periods: placebo, high- or low-dose ramipril, crossover to low- or high-dose ramipril, and placebo. Blood pressure, glomerular filtration rate, renal plasma flow rate, urinary protein excretion rate, and plasma angiotensin II levels were measured at the end of each period. Mean arterial pressure, urine protein to creatinine ratio, and albumin excretion rate decreased significantly during low- and high-dose ramipril. Glomerular filtration rate and renal plasma flow rate were not changed significantly. Plasma angiotensin II levels decreased with both low- and hi...Continue Reading

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Citations

Mar 20, 2003·Current Diabetes Reports·Robert D Toto
Aug 19, 2009·Pediatric Transplantation·Tomás SeemanJan Janda
Feb 29, 2000·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·P RuggenentiG Remuzzi

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