Document Detail

Renal hemodynamics and renoprotection.
MedLine Citation:
PMID:  18974652     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Angiotensin II (AII) is the well-known determinant of kidney damage increasing intraglomerular pressure, matrix expansion and fibroblast proliferation. Renin-angiotensin system (RAS) inhibition, limiting the hemodynamic effects of AII, reduces proteinuria and is renoprotective in the long term. METHODS: We studied 15 chronic proteinuric patients by Doppler ultrasonography to clarify the intrarenal hemodynamic changes during RAS blockade by Benazepril (10-20 mg/day) alone and combined with Valsartan (80-160 mg/day). We also investigated the correlation between hemodynamic indices, RAS components and antiproteinuric effect. RESULTS: After 1 month of Benazepril proteinuria, resistive index (RI) and pulsatility index (PI) significantly decreased and proteinuria reduction was directly correlated to decrease in RI (r = 0.55, p = 0.03). Contrarily, after 1 month of combined therapy, RI and PI restored to baseline and progressively increased in the following 3 months, while proteinuria decreased. Increase in RI was directly correlated to concomitant increase in plasma renin activity (r = 0.65, p = 0.01) suggesting a direct role of renin in restoring intrarenal resistances. CONCLUSION: The hemodynamic changes caused by RAS inhibitors partially contribute to the antiproteinuric effect. Other RAS components, such as renin, may contribute to renal vasoconstriction and could be a further determinant of kidney damage besides a promising target for renoprotection.
Giacomina Loriga; Gianpaolo Vidili; Piero Ruggenenti; Rossana Faedda; Marcella Sanna; Andrea E Satta
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-10-31
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  110     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c213-9     Citation Subset:  IM    
Copyright Information:
(c) 2008 S. Karger AG, Basel.
Internal Medicine Department, University of Sassari, Sassari, Italy.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Benzazepines / administration & dosage
Hypertension, Renal / physiopathology*,  prevention & control*
Middle Aged
Proteinuria / physiopathology*,  prevention & control*
Renal Circulation / drug effects*
Renin / metabolism
Renin-Angiotensin System / drug effects*
Tetrazoles / administration & dosage
Treatment Outcome
Valine / administration & dosage,  analogs & derivatives
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Benzazepines; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine; 86541-75-5/benazepril; EC

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