The influence of angiotensin-converting enzyme inhibition on renal tubular function in progressive chronic nephropathy

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
A L KamperS Strandgaard

Abstract

The influence of angiotensin-converting enzyme (ACE) inhibition on renal tubular function in progressive chronic nephropathy was investigated in 69 patients by the lithium clearance (C(Li)) method. Studies were done repeatedly for up to 2 years during a controlled trial on the effect of enalapril on progression of renal failure. The pattern of proteinuria was followed over the first 9 months. At baseline, the glomerular filtration rate (GFR) was 5 to 68 mL/min. Absolute proximal tubular reabsorption rate of fluid (APR), estimated as the difference between GFR and C(Li), was 1 to 54 mL/min. Calculated fractional proximal reabsorption (FPR) was moderately subnormal. During the study, GFR decreased and sodium clearance was unchanged; fractional excretion of sodium therefore increased. In the group of patients randomized to treatment with enalapril (n = 34), GFR at 1 month was 83% (P < 0.001) and C(Li) was 88% (P < 0.01) of the baseline values, APR and FPR had not changed significantly, and potassium clearance was significantly decreased. Through the rest of the study period, APR remained nearly unchanged and FPR even increased in the enalapril group. In the group of patients randomized to treatment with conventional antihypertensi...Continue Reading

Citations

Jun 27, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Arlene B Chapman
Mar 7, 2002·Journal of the Renin-angiotensin-aldosterone System : JRAAS·T Elung-JensenN E Larsen
Apr 1, 2008·Journal of Evaluation in Clinical Practice·Samina Khan, Chester A Amedia

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