Short-term effect of captopril on renal haemodynamics in chronic renal failure

Glomerular filtration rate (GFR), effective renal plasma flow, and creatinine clearance were measured in ten patients with stable chronic renal failure (GFR less than 50 ml/min) before, during and after 1 month's treatment with captopril. Plasma angiotensin II decreased significantly during tre...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 1989, Vol.4 (8), p.696-700
Main Authors: SMITH, W. G. J, DHARMASENA, A. D, EL NAHAS, A. M, THOMAS, D. M, COLES, G. A
Format: Article
Language:English
Subjects:
Adult
Aged
Antihypertensive agents
Biological and medical sciences
Blood Pressure - drug effects
Captopril - administration & dosage
Captopril - pharmacology
Cardiovascular system
Creatinine - metabolism
Dietary Proteins - administration & dosage
Drug Administration Schedule
Female
Glomerular Filtration Rate - drug effects
Humans
Kidney Failure, Chronic - metabolism
Kidney Failure, Chronic - physiopathology
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Renal Circulation - drug effects
Renin-Angiotensin System - drug effects
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Summary:Glomerular filtration rate (GFR), effective renal plasma flow, and creatinine clearance were measured in ten patients with stable chronic renal failure (GFR less than 50 ml/min) before, during and after 1 month's treatment with captopril. Plasma angiotensin II decreased significantly during treatment (P less than 0.05) and increased after the drug was stopped. Renin concentration increased with captopril (P less than 0.02) and urine protein excretion decreased (P less than 0.05). Blood pressure did not change in any individual. There was no alteration in baseline GFR, effective renal plasma flow, or creatinine clearance, with or without captopril. Following a high-protein meal there was no increase in any of the measured renal haemodynamic parameters before, during, or after taking the drug. There was a significant increase in plasma creatinine while taking captopril (P less than 0.02) which reversed on cessation of the drug. These results suggest that in stable chronic renal failure the human renal microvasculature is unresponsive to inhibitors of angiotensin-converting enzyme.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/4.8.696