Effects of Enalapril versus Placebo as a Treatment for Canine Idiopathic Glomerulonephritis

Abstract

A blinded, multicenter, prospective clinical trial assessed the effects of enalapril (EN) versus standard care in dogs with naturally occurring, idiopathic glomerulonephritis (GN). Twenty-nine adult dogs with membranous (n 16) and membranoproliferative (n 13) GN were studied. Dogs were randomly assigned to receive either EN (0.5 mg/kg PO q12-24h; n 16) or placebo (n 14) for 6 months (1 dog was treated first with the placebo and then with EN). All dogs were treated with low-dose aspirin (0.5-5 mg/kg PO q12-24h) and fed a commercial diet. At baseline, serum creatinine (SrCr), systolic blood pressure (SBP), and glo-merular histologic grade were not different between groups, but the urine protein/creatinine ratio (UP/C) was greater in the EN group compared with the placebo group (8.7 4.4 versus 4.7 2.3). After 6 months of treatment, the change in UP/C from baseline was significantly different between groups (EN 4.2 1.4 versus 1.9 0.9 in the placebo group). When data were adjusted for changes in SrCr (SrCr UP/C) a similar significant reduction was noted (2.2 15.2 versus 8.4 10.1). The change in SBP after 6 months of treatment also was significantly different between groups (EN 12.8 27.3 versus 5.9 21.5 mm Hg in the placebo group). Response to treatment was categorized as improvement (assigned a value of 2), no progression (assigned a value of 1), and progression (assigned a value of 0). Response was significantly better in the EN group (1.4 0.8) compared with the placebo group (0.3 0.5). These results suggest that EN treatment is beneficial in dogs with naturally occurring idiopathic GN.

Development of Hypertension and Effects of Benazepril Hydrochloride in a Canine Remnant Kidney Model of Chronic Renal Failure

“…Since the advent of ACE inhibitors, various types of ACE inhibitor have been developed and, along with ANG receptor blockers, have become mainstay conservative treatments for chronic renal failure in humans [8,18,35,42]. Effects of such ACE inhibitors as enalapril and benazepril on renal failure are also being recognized in dogs and cats [9,10,15]. Benazepril hydrochloride has the merit of being excreted in bile and urine, a characteristic not found in other ACE inhibitors [40].…”

Management of Proteinuria in Dogs and Cats with Chronic Kidney Disease

“…In cats with naturally occurring chronic kidney disease, benazepril was associated with a reduction in proteinuria, even in the subgroup of cats with initial UPC of <0. Initially an ACEi is given once daily, but more than half of the dogs will need twice daily administration eventually and perhaps additional dosage escalations ( Figure 2) (Grauer et al, 2000). Many veterinarians are concerned about administering an ACEi to a dog or cat that is already azotemic.…”

Effect of common storage temperatures and container types on urine protein : creatinine ratios in urine samples of proteinuric dogs

“…In dogs, a positive correlation between magnitude of proteinuria and time to uremic crisis or death has been reported 5. Additionally, an association between use of medications that typically cause a reduction in magnitude of proteinuria in patients with chronic kidney disease and improved renal outcome measures has been reported in human and veterinary patients 6, 7, 8, 9, 10, 11, 12. The urine protein : creatinine ratio (UPC) is a common method for assessing the magnitude of proteinuria in dogs, and strongly correlates with 24‐hours urine protein excretion 13.…”