| Renal protective effects of enalapril in hypertensive NIDDM: role of baseline albuminuria. | |
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MedLine Citation:
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PMID: 8158885 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The primary results of a three-year prospective, double-blind, placebo-controlled trial in non-insulin-dependent diabetic (NIDDM) patients show that an anti-hypertensive regimen, which includes the ACE inhibitor enalapril, preserves renal function to a greater extent than therapy with antihypertensive agents excluding ACE inhibitors (J Am Soc Nephrol 3:335, 1992). The influence of baseline urinary albumin excretion on the renal protective effects of enalapril treatment in these subjects was the objective of this further analysis. Adequate data were available in 121 patients of the 165 hypertensive NIDDM individuals studied [baseline glomerular filtration rate (GFR) 30 to 100 ml/min/1.73 m2]. Twenty-four hour urinary excretion of albumin (UAE), protein, urea nitrogen, creatinine and isotopically determined GFR were measured at baseline and six month intervals. Glycemic control and blood pressure regulation were assessed every three months. The rate of loss of GFR was significantly greater in patients with overt proteinuria at baseline (UAE > 300 mg/24 hr) as compared to patients with baseline sub-clinical proteinuria (UAE < or = 300 mg/24 hr). Antihypertensive treatment with enalapril preserved GFR significantly better (P < 0.01) in the patients with sub-clinical proteinuria at baseline (UAE < or = 300 mg/24 hr) than other antihypertensive treatments which excluded the ACE inhibitor. Furthermore, only 7% of the enalapril-treated group progressed to clinical albuminuria compared to 21% of control treated patients. Although the enalapril-treated group had a lower mean blood pressure during the maintenance period, no correlation between blood pressure (systolic, diastolic or mean arterial) and rate of change of GFR was observed.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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H E Lebovitz; T B Wiegmann; A Cnaan; S Shahinfar; D A Sica; V Broadstone; S L Schwartz; M C Mengel; R Segal; J A Versaggi |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Kidney international. Supplement Volume: 45 ISSN: 0098-6577 ISO Abbreviation: Kidney Int. Suppl. Publication Date: 1994 Feb |
Date Detail:
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Created Date: 1994-05-19 Completed Date: 1994-05-19 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7508622 Medline TA: Kidney Int Suppl Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: S150-5 Citation Subset: IM |
Affiliation:
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Downstate Medical Center, Brooklyn, New York. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Diabetes Mellitus, Type 2* Diabetic Angiopathies / drug therapy*, physiopathology, urine Double-Blind Method Enalapril / therapeutic use* Glomerular Filtration Rate Humans Hypertension / drug therapy*, physiopathology, urine Kidney / drug effects* Prospective Studies |
| Grant Support | |
ID/Acronym/Agency:
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RR 00318/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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75847-73-3/Enalapril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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