A Fiveyear Comparison of the Renal Protective Effects of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with NonDiabeticNephropathy

Shoda, Junko; Kanno, Yoshihiko; Suzuki, Hiromichi

doi:10.2169/internalmedicine.45.1515

Cited by 29 publications

(20 citation statements)

References 22 publications

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“…13 Angiotensin receptor blockers prevent acute renal failure and delay the process of chronic kidney disease. 13,32 Our previous studies showed that serum and urinary ACE activities were increased 24 h-48 h after contrast media administration. 14 The renal Ang II levels in contrast media groups were higher than control groups and telmisartan protected renal tissue from nephrotoxicity induced by contrast media in glycerin-treated rats.…”

Section: Discussionmentioning

confidence: 99%

Aged Rats Are Susceptible to Nephrotoxicity Induced by Iodinated Contrast Media

et al. 2012

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Objective: The objective of this study is to evaluate the effect and mechanism of aging on iodinated-contrast-mediainduced nephropathy in male rats. Methods: Twenty-four healthy male rats were initially divided into 12-month-old and 24-month-old age groups (adult and older age groups, respectively; n ¼ 12/group); subsequently, each age group was randomly divided into saline control (NS) and contrast media (CM) groups (n ¼ 6/group). CM (76% diatrizoate, 10 mL/kg b.w.) was given through the caudal vein. Urinary creatinine (Ucr) and serum creatinine (Scr) were detected by an automatic biochemical analyzer. The activities of renal malondialdehyde (MDA), superoxide dismutase (SOD), angiotensinconverting enzyme (ACE), angiotensin II (Ang II), and reduced form of nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) were determined by spectrophotometric assays with commercially available kits according to the manufacturers' protocols. Renal histological changes were observed by hematoxylin and eosin staining and scored semiquantitatively. Results: In diatrizoate-injected aged rats, Scr, the activities of ACE, Ang II, MDA, and NADPH oxidase in renal tissues were significantly increased (p < 0.01). The histologic scores were higher in the aged animals with CM treatment than those of control or adult rats (p < 0.01). There was an increasing trend but no significant statistical difference in renal ACE, Ang II, MDA, and NADPH oxidase or histologic scores in adult CM-injected rats compared with control animals (p > 0.05). Conclusions: Older age is an aggravating factor of iodinated-contrast-media-induced nephropathy in male rats. Oxidative stress and the renin-angiotensin system (RAS) may play an important role in nephrotoxicity induced by iodinated contrast media, especially in aged male rats.

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Section: Discussionmentioning

confidence: 99%

Aged Rats Are Susceptible to Nephrotoxicity Induced by Iodinated Contrast Media

et al. 2012

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“…The issue of whether ARBs and ACE inhibitors are similarly effective in CKD that is not caused by diabetic nephropathy remains controversial (72,73).…”

Section: Prevention Treatment and Follow Upmentioning

confidence: 99%

Chronic Kidney Disease in Diabetes

McFarlane¹,

Gilbert²,

MacCallum³

et al. 2013

Canadian Journal of Diabetes

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“…Head-to-head comparisons of the 2 classes of drugs are scanty [15,16]. Barnett et al [15] made a double-blind trial on 250 subjects with type 2 diabetes and early nephropathy who were randomly assigned to receive either telmisartan or enalapril.…”

Section: Do Ace Inhibitors and Arbs Equally And Fully Suppress The Ras?mentioning

confidence: 99%

“…However, these findings do not necessarily apply to patients with more advanced nephropathy or non-diabetic CKD. Shoda et al [16] studied 68 non-diabetic patients with CKD and proteinuria, showing again no difference among the 2 classes of drugs. Unfortunately, the value of these findings is limited by the fact that study treatment was quite heterogeneous in the 2 groups.…”

Section: Do Ace Inhibitors and Arbs Equally And Fully Suppress The Ras?mentioning

confidence: 99%

Inhibition of the Renin-Angiotensin System in Chronic Kidney Disease: A Critical Look to Single and Dual Blockade

Locatelli

Vecchio

Cavalli³

2009

Nephron Clin Pract

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The clinical benefits of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) are well established in chronic kidney disease (CKD) patients with diabetic and non-diabetic nephropathies. But despite appearance, the magnitude of this effect has been questioned particularly in mild, proteinuric nephropathies. Given that the single agents can achieve only partial and not durable suppression of the renin-angiotensin system (RAS), it has been hypothesized that dual blockage with ACE inhibitors and ARBs would be most beneficial in the management of progressive CKD than either agent alone. Available evidence indicates significant anti-proteinuric effect, but long-term data in CKD patients are lacking. Recently, the findings of the ONTARGET trial even questioned the safety of this therapeutic approach. Given that preventing cardiovascular complications is extremely important in CKD and RAS inhibition may be useful in this setting, benefits of RAS blockade must be weighed against its possible adverse effects particularly in elderly patients.

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A Fiveyear Comparison of the Renal Protective Effects of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with NonDiabeticNephropathy

Abstract: Objective Evidence suggests that the effectiveness of angiotensin-converting enzyme (ACE) inhibition diminishes with time, resulting in increasing angiotensin

Cited by 29 publications

References 22 publications

Aged Rats Are Susceptible to Nephrotoxicity Induced by Iodinated Contrast Media

Aged Rats Are Susceptible to Nephrotoxicity Induced by Iodinated Contrast Media

Chronic Kidney Disease in Diabetes

Inhibition of the Renin-Angiotensin System in Chronic Kidney Disease: A Critical Look to Single and Dual Blockade

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