Angiotensin-Converting Enzyme Inhibitors: Therapeutic Implications in the Management of Chronic Renal Failure

2015 ◽  
pp. 240-247
Author(s):  
A. M. El Nahas
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Therapeutic Implications

Differences in the effects of angiotensin converting enzyme inhibitors with or without a thiol group in chronic renal failure in rats

1989 ◽  
Vol 76 (4) ◽  
pp. 353-356 ◽  
Author(s):  
Akira Ohishi ◽  
Hiromichi Suzuki ◽  
Hidetomo Nakamoto ◽  
Hiroshige Katsumata ◽  
Hiroshi Sakaguchi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Enzyme Inhibitor ◽  
Thiol Group ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Control Group ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

1. We have investigated the effects of the non-renin-mediated actions of angiotensin converting enzyme inhibitors on the progression of chronic renal failure accelerated by hypertension. For this purpose, we studied the effects of captopril (a thiol-containing angiotensin converting enzyme inhibitor), enalapril (an angiotensin converting enzyme inhibitor without a thiol group) and cysteine (a thiol-containing amino acid which has no angiotensin converting enzyme-inhibitory action) in adriamycin-treated rats with deoxycorticosterone acetate-salt hypertension, in which the renin-angiotensin system was suppressed. 2. There were no significant differences in blood pressure between these groups and the control group [adriamycin-treated group with deoxycorticosterone acetate-salt loading, 206 ± 7 mmHg (27.4 ± 0.9 kPa) at week 10]. 3. Massive proteinuria occurred in all groups. At the end of the experiment (at week 10), urinary protein excretion was significantly reduced in the captopril and cysteine groups compared with the control group. No manifest improvements appeared in the enalapril group. 4. Levels of serum creatinine and blood urea nitrogen increased progressively. At week 10, the increases in the serum levels of creatinine were less in the captopril (87 ± 16 mmol/l) and cysteine (80 ± 19 mmol/l) groups than in the control group (124 ± 27 mmol/l) (P < 0.01). No marked differences were found between the control and enalapril groups. 5. Captopril and cysteine caused more than a threefold reduction in the focal glomerulosclerosis score when compared with that in the control group, but enalapril did not decrease the score. The extent of tubulo-interstitial change was parallel with the focal glomerulosclerosis score. 6. We conclude that the thiol group is possibly involved in the mechanism of the beneficial effects of some angiotensin converting enzyme inhibitors on the progression of chronic renal failure exacerbated by hypertension.

Dangers of Captopril Therapy in Newborns

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1076-1076
Author(s):  
VIVIAN REZNIK ◽  
WILLIAM GRISWOLD ◽  
STANLEY MENDOZA
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Angiotensin Converting Enzyme ◽  
Premature Infant ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Treatment Of Hypertension

Angiotensin-converting enzyme inhibitors are effective at lowering blood pressure in the neonate and the child. However, these drugs, when used for the treatment of hypertension in the premature infant, must be used with caution to avoid the complications that are well documented in the literature. All of the infants described in the article by Perlman and Volpe had extreme hypotension and oligunia. A group of nine infants with renal failure complicating captopril therapy were recently reported from the same institution.

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