Document Detail

The effects of enalapril on urinary protein excretion in patients with idiopathic membranous nephropathy.
MedLine Citation:
PMID:  2312767     Owner:  NLM     Status:  MEDLINE    
High doses of the angiotensin converting enzyme inhibitor, captopril, is known to cause significant increases in urinary protein excretion in patients with idiopathic membranous nephropathy. To find whether other angiotensin converting enzyme inhibitors yield similar results, we prospectively examined the effect of enalapril in five consecutive patients with idiopathic membranous nephropathy, elevated arterial pressure, and proteinuria and compared them to age-matched controls receiving clonidine. Glomerular filtration rate, 24-hour urinary protein excretion, and arterial pressure were measured. All patients served as their own controls. Those who received enalapril demonstrated an initial increase in proteinuria (-0.3 +/- 0.7 delta gm/day, clonidine vs 3.9 +/- 0.9 delta gm/day, enalapril: P less than .05) despite similar decreases in arterial pressure (-18 +/- 6 delta mm Hg, clonidine vs -22 +/- 6 delta mm Hg, enalapril: NS) and glomerular filtration rate (-1.1 +/- 0.8 delta mL/min, clonidine vs -1.9 +/- 1.2 delta mL/min, enalapril: NS) when compared to the clonidine group. This increase in proteinuria, however, did not occur when these patients were rechallenged with enalapril. To our knowledge, this is the first report to document a significant increase in preexisting nephrotic range proteinuria following administration of nonsulfhydryl ACE inhibitor. This increase, however, appears to be unique to the initial treatment phase of the disease and does not affect long-term management.
E R Sauter; G L Bakris
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical pharmacology     Volume:  30     ISSN:  0091-2700     ISO Abbreviation:  J Clin Pharmacol     Publication Date:  1990 Feb 
Date Detail:
Created Date:  1990-04-26     Completed Date:  1990-04-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366372     Medline TA:  J Clin Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  155-8     Citation Subset:  IM    
Department of Medicine, Ochsner Clinic, New Orleans, LA 70121.
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MeSH Terms
Blood Pressure
Clonidine / administration & dosage,  pharmacology*
Enalapril / administration & dosage,  pharmacology*
Glomerulonephritis, Membranous / urine*
Hypertension / urine
Middle Aged
Prospective Studies
Proteinuria / chemically induced*
Reg. No./Substance:
4205-90-7/Clonidine; 75847-73-3/Enalapril

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

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