Document Detail

Angiotensin-converting enzyme gene polymorphism determines the antiproteinuric and systemic hemodynamic effect of enalapril in patients with proteinuric renal disease. Austrian Study Group of the Effects of Enalapril Treatment in Proteinuric Renal Disease.
MedLine Citation:
PMID:  9661139     Owner:  NLM     Status:  MEDLINE    
Angiotensin-converting enzyme (ACE) inhibitors are known to reduce blood pressure and proteinuria in a variety of different glomerular diseases. Nonetheless, a marked interindividual difference in the efficacy of these agents exists. The activity of the ACE and therefore of the renin-angiotensin-aldosterone system (RAAS) has been shown to be under genetic influence. Patients with a deletion genotype at the intron 16 of the ACE gene have been shown to exhibit higher activity of plasmatic ACE when compared to patients with the insertion genotype. We therefore studied prospectively the hemodynamic and antiproteinuric effect of a 6-month therapy with enalapril in patients with biopsy-proven proteinuric glomerular diseases and the DD (n = 10) and ID/II (n = 26) genotype. Although patients with the DD genotype received a slightly higher dose of enalapril, blood pressure and proteinuria did not change significantly. However, both were significantly reduced in the II/ID group after 10 weeks and 6 months of therapy. Creatinine clearance decreased steadily in DD patients. In II/ID patients, creatinine clearance was reduced significantly after 10 weeks of therapy but increased again thereafter and the value at 6 months was again comparable to the one obtained in the DD patients. We conclude from our study that the ACE genotype influences the blood pressure-lowering and antiproteinuric effect of enalapril in patients with proteinuric glomerular disease.
M Haas; N Yilmaz; A Schmidt; U Neyer; K Arneitz; H K Stummvoll; M Wallner; M Auinger; I Arias; B Schneider; G Mayer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney & blood pressure research     Volume:  21     ISSN:  1420-4096     ISO Abbreviation:  Kidney Blood Press. Res.     Publication Date:  1998  
Date Detail:
Created Date:  1998-09-21     Completed Date:  1998-09-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9610505     Medline TA:  Kidney Blood Press Res     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  66-9     Citation Subset:  IM    
Department of Internal Medicine III, University of Vienna, Austria.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Creatinine / metabolism
DNA / analysis
Enalapril / therapeutic use*
Follow-Up Studies
Hemodynamics / drug effects*
Middle Aged
Peptidyl-Dipeptidase A / drug effects,  genetics*
Polymerase Chain Reaction
Polymorphism, Genetic*
Prospective Studies
Proteinuria / drug therapy,  metabolism*,  physiopathology
Sodium / urine
Treatment Outcome
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 60-27-5/Creatinine; 7440-23-5/Sodium; 75847-73-3/Enalapril; 9007-49-2/DNA; EC A

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