RT Journal Article
SR Electronic
T1 Use of angiotensin-converting enzyme inhibitors in chronic progressive renal disease
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 184
OP 190
VO 58
IS 2
A2 Brouhard, Ben H.
A1 Irwin, Kimberly C.
A1 Cunningham, Robert J.
A1 Stowe, Nicholas T.
YR 1991
UL http://www.ccjm.org/content/58/2/184.abstract
AB 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.