Comparison of the renal effects of different angiotensin-converting enzyme inhibitors in patients with chronic renal diseases

Kaizu, Kazo; Sun, Xin; Uriu, Kohei; Ikeda, Masanori; Hashimoto, Osamu; Komine, Norikuni; Takagi, Ichiro; Qie, Yue Ling; Inada, Y; Ito, Aki; Eto, Sumiya

doi:10.1007/s101570200004

Cited by 2 publications

(2 citation statements)

References 28 publications

(27 reference statements)

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“…It is not clear, however, whether adjusted-dose enalapril had a renoprotective effect or not from our study, since we did have a control cohort. However, as we have already demonstrated that adjusted-dose ACE-I had effects not only to decrease the urinary protein and albumin and blood aldosterone, but also to increase PRA [21], it seems plausible that even adjusted-dose enalapril could contribute at least partly as a renoprotective drug. Adjusted-dose ACE-I did not induce any side effects such as hyperkalemia or a transient decline of GFR in patients with marked renal failure.…”

Section: Discussionmentioning

confidence: 99%

“…GFR less than 30 ml/min, has been clarified as yet [20]. Therefore, we adjusted the dose of enalapril according to 24-hour creatinine clearance by a formula [21] in order to avoid side effects such as hyperkalemia, rapid increases in serum creatinine and decline of renal function [20]. We needed to do so since we intended to administer this drug to the patients with very profound renal failure until the initiation of RRT.…”

Section: Dietmentioning

confidence: 99%

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Clinical Profiles and Outcomes of End-Stage Renal Failure Patients with Late Initiation of Renal Replacement Therapy Based on Uremic Symptoms under Intensive Renoprotective Therapies

Kaizu

Uriu²,

Inada³

et al. 2002

Am J Nephrol

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Aim: This study describes the clinical profiles and outcomes of renal failure patients with late initiation of renal replacement therapies (RRT) based on uremic symptoms under intensive treatment prior to the start of RRT (IT). Methods: Thirteen patients (male 10, female 3) with end-stage renal disease who preferred to wait for the initiation of RRT until uremic symptoms appeared regardless of serum creatinine (s-Cr) and 24-hour creatinine clearance (24-hour Ccr) were chosen. All patients received IT including a low-protein diet, antihypertensive drugs including enalapril, erythropoietin and others to prevent and manage uremic states until the initiation of RRT. Clinical findings at the initiation of RRT and the outcomes after the start of RRT were examined. Results: RRT was initiated 23.6 ± 16.9 months after IT without any complication in all patients when mild uremic symptoms appeared. Uremic symptoms, blood pressure, serum albumin, potassium, calcium and urinary Cr excretion were well controlled except inorganic phosphate, hemoglobin and cardiac size. 24-hour Ccr and s-Cr were 3.4 ± 0.7 ml/min and 17.4 ± 3.8 mg/dl at initiation of RRT. The outcomes of all the patients were all well during chronic RRT. Conclusion: Intensive treatment prior to the start of RRT can diminish uremic symptoms and complications so that RRT might be initiated safely and with fewer problems, even in the face of lower 24-hour Ccr and markedly higher s-Cr.

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Section: Discussionmentioning

confidence: 99%

Section: Dietmentioning

confidence: 99%

Clinical Profiles and Outcomes of End-Stage Renal Failure Patients with Late Initiation of Renal Replacement Therapy Based on Uremic Symptoms under Intensive Renoprotective Therapies

Kaizu

Uriu²,

Inada³

et al. 2002

Am J Nephrol

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Benefits of delapril in hypertensive patients along the cardiovascular continuum

González-Juanatey¹,

Cordero

2013

Expert Review of Cardiovascular Therapy

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Angiotensin-converting enzyme inhibitors (ACEIs) are the first-line therapy for the treatment of hypertension. However, not all ACEIs are equal. Delapril is a nonsulfhydryl ACEI with unique properties. Delapril has a high lipophilicity and weak bradykinin potentiating action. As a result, delapril has a more potent inhibition capacity of vascular wall angiotensin-converting enzyme activity and a lower incidence of cough than enalapril or captopril. With regard to efficacy, delapril has a long-lasting antihypertensive effect with a trough/peak ratio that is in the upper range of different ACEIs and a positively high smoothness index. Thus, delapril effectively and smoothly reduces blood pressure over 24 h. Moreover, the benefits of delapril are not limited to hypertensive patients, but also in those with microalbuminuria, left ventricular hypertrophy, myocardial infarction or heart failure; delapril appears to be effective and well tolerated.

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Comparison of the renal effects of different angiotensin-converting enzyme inhibitors in patients with chronic renal diseases

Cited by 2 publications

References 28 publications

Clinical Profiles and Outcomes of End-Stage Renal Failure Patients with Late Initiation of Renal Replacement Therapy Based on Uremic Symptoms under Intensive Renoprotective Therapies

Clinical Profiles and Outcomes of End-Stage Renal Failure Patients with Late Initiation of Renal Replacement Therapy Based on Uremic Symptoms under Intensive Renoprotective Therapies

Benefits of delapril in hypertensive patients along the cardiovascular continuum

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