Document Detail


Prediction of renal impairment in elderly patients with congestive heart failure treated with captopril.
MedLine Citation:
PMID:  8723173     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study assessed the usefulness of the oral captopril test in the prediction of renal impairment among elderly patients with congestive heart failure (CHF). Forty-seven patients aged > or = 65 years with CHF (EF < 40%) participated in a prospective nonrandomized series. Blood samples for plasma renin activity (PRA) were drawn before and 60 minutes after 50 mg of oral captopril. Twenty-four hours later, captopril was administered (up to 75 mg/day over a 4 day period), and renal laboratory and clinical assessment were performed at baseline and for a 9 day period. In 7 of 47 patients (14.9%), deterioration of renal function was observed. During the captopril test, the PRA increased significantly after 1 hour in almost all patients and the mean blood pressure decreased from 99.2 +/- 14.6 mmHg to 92.2 +/- 13.7 mmHg (p < 0.001). All patients whose baseline PRA level was < 1.9 ng/ml/hr and whose stimulated PRA was < 3.2 ng/ml/hr maintained a stable renal function throughout the study period. Significant statistical correlation (p < 0.05) was found between the initial PRA, the changes in PRA or mean blood pressure during the captopril test, and the change in plasma creatinine and creatinine clearance in the entire group, and was even more evident in a subgroup of patients with an ejection fraction > or = 30%. All these correlations were not statistically significant in the patients with an ejection fraction < 30%. It is thus concluded that measurement of pretreatment PRA levels might be a useful laboratory tool for predicting the renal safety of captopril use in patients with CHF whose EF > or = 30%.
Authors:
D Schwartz; R Kornowski; I F Schwartz; I Dotan; B Weinreb; M Averbuch; Y Golan; Y Levo; A Iaina
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  10     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-10-01     Completed Date:  1996-10-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  75-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine T, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, Israel.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  diagnostic use*,  therapeutic use
Captopril / adverse effects,  diagnostic use*,  therapeutic use
Creatinine / blood
Female
Heart Failure / drug therapy*
Humans
Kidney / drug effects*,  metabolism
Kidney Diseases / chemically induced
Male
Predictive Value of Tests
Prospective Studies
Renin / blood*
Safety
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 60-27-5/Creatinine; 62571-86-2/Captopril; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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