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Bench to Bedside

Use of angiotensin-converting enzyme inhibitors in chronic progressive renal disease

Kimberly C. Irwin, MD, Robert J. Cunningham, MD and Nicholas T. Stowe, PHD
Cleveland Clinic Journal of Medicine March 1991, 58 (2) 184-190;
Ben H. Brouhard
Department of Pediatrics
Department of Hypertension and Nephrology
Department of Pediatrics, Heart and Hypertension Research
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Kimberly C. Irwin
Department of Pediatrics
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Robert J. Cunningham
Department of Pediatrics
Hypertension and Nephrology
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Nicholas T. Stowe
Department of Hypertension and Nephrology
Department of Urology
Department of the Nephro-Urology Research Laboratory
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ABSTRACT

Chronic renal insufficiency is a progressive, self-perpetuating process which is influenced in part by activation of the intrarenal renin-angiotensin system. Oral angiotensin-converting enzyme inhibitors are being studied in animals and humans to determine whether they slow the decline in renal function characteristic of progressive renal disease. In animals that have reduced renal mass, streptozotocin-induced diabetes mellitus, or puromycin aminonucleoside nephrosis, these agents can reduce proteinuria, decrease the frequency of sclerotic glomeruli, and normalize intrarenal hemodynamics. They also may decrease glomerular hypertrophy that occurs after renal ablation. In human trials, angiotensin-converting enzyme inhibitors decrease proteinuria by altering the glomerular capillary permeability. The effect of these agents on progressive disease may be influenced by how soon therapy is begun and how long it is continued.

INDEX TERMS
  • Angiotensin-Converting Enzyme Inhibitors
  • Renal Disease
  • Chronic Progressive
  • Copyright © 1991 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 58 (2)
Cleveland Clinic Journal of Medicine
Vol. 58, Issue 2
1 Mar 1991
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Use of angiotensin-converting enzyme inhibitors in chronic progressive renal disease
Kimberly C. Irwin, Robert J. Cunningham, Nicholas T. Stowe
Cleveland Clinic Journal of Medicine Mar 1991, 58 (2) 184-190;

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Use of angiotensin-converting enzyme inhibitors in chronic progressive renal disease
Kimberly C. Irwin, Robert J. Cunningham, Nicholas T. Stowe
Cleveland Clinic Journal of Medicine Mar 1991, 58 (2) 184-190;
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Keywords

  • Angiotensin-Converting Enzyme Inhibitors
  • Renal Disease
  • Chronic Progressive

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