These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Angiotensin-converting enzyme inhibitors in diabetes: effect on the kidney and on blood pressure.
    Author: Björck S, Aurell M.
    Journal: J Am Soc Nephrol; 1990 Nov; 1(5 Suppl 2):S59-63. PubMed ID: 16989067.
    Abstract:
    In diabetes mellitus, studies on the renin angiotensin system conflict. Among type I diabetic patients, we have found normal plasma renin activity and angiotensin II levels. In these patients, low-dose angiotensin II infusion resulted in the same effect on renal hemodynamics as that observed in healthy controls. In patients with diabetic nephropathy, a disease usually regarded as a low-renin condition, we have found elevated levels of plasma renin activity as compared with that seen in healthy persons and control subjects with other renal diseases that result in a similar degree of renal failure. In patients with diabetic nephropathy, interruption of the renin angiotensin system with angiotensin-converting enzyme inhibitors has been associated with a reduction in proteinuria. It is not clear whether this is a result of blood pressure reduction or a specific effect of these drugs. In a randomized trial with patients with diabetic nephropathy, we found that enalapril treatment reduced proteinuria to less than half the level obtained in a metoprolol-treated group during equally effective blood pressure control. In a long-term prospective study of captopril in patients with diabetic nephropathy, the rate of decline in kidney function was reduced to half the value that was calculated during a retrospective period. The renin angiotensin system, therefore, can be normally active in patients with diabetic nephropathy, and angiotensin-converting enzyme inhibitors can reduce proteinuria by mechanisms independent of their effect on blood pressure. Long-term treatment may protect renal function to a greater degree than might be expected from the blood pressure-lowering effect.
    [Abstract] [Full Text] [Related] [New Search]