Effects of diltiazem or lisinopril on massive proteinuria associated with diabetes mellitus

Article Abstract:

The excretion of protein in the urine (proteinuria) is generally thought to be an indicator of deteriorating kidney function. While drugs which lower high blood pressure (hypertension) may all contribute to the preservation of kidney function, experiments in diabetic rats with hypertension have shown that the drugs which function by inhibiting angiotensin-converting enzyme are more effective in reducing proteinuria than other antihypertensive drugs. Drugs which act as calcium channel antagonists vary in their influence on proteinuria. A study was conducted to measure the effects of the drug diltiazem, a calcium channel antagonist which has effects similar to the angiotensin-converting enzyme inhibitors. In eight patients with noninsulin-dependent diabetes and hypertension, diltiazem was compared with lisinopril. Both drugs significantly decreased the urinary excretion of protein without changing the creatinine clearance, indicating improved kidney function. Both diltiazem and lisinopril were effective at reducing blood pressure during the treatment period. There were no significant differences between diltiazem and lisinopril. A larger study would be required to fully evaluate the effectiveness of these medications in the management of diabetic kidney disease. However, the evidence suggests that these two drugs may be of value, and that diltiazem may serve as a good alternative for diabetic patients with allergy to lisinopril or other reasons why they should not take it. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hypertension, Causes of, Complications and side effects, Type 2 diabetes, Kidney diseases, Diltiazem, Lisinopril

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Improvement of lipid abnormalities associated with proteinuria using fosinopril, an angiotensin-converting enzyme inhibitor

Article Abstract:

The angiotensin-converting enzyme fosinopril may be an effective treatment for elevated blood lipid levels in patients suffering from proteinuric kidney disease. Abnormal blood lipid levels are often a complication of proteinuria, or excretion of increased levels of protein in the urine. Among 26 patients between 28 and 70 years old suffering from proteinuric kidney disease, 17 were treated with fosinopril and nine were treated with a placebo, or an inactive substance. Patients treated with fosinopril experienced a significant reduction in the amount of protein excreted in the urine, but patients who received a placebo did not experience a significant reduction. Blood levels of cholesterol and of plasma lipoprotein(a) fell significantly in the patients treated with fosinopril, but they did not decline in the patients who received a placebo.

Angiotensin converting enzyme, Hyperlipidemia

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Effects of sodium intake on albumin excretion in patients with diabetic nephropathy treated with long-acting calcium antagonists

Article Abstract:

A low-sodium diet appears to enhance the beneficial effects of some antihypertensive drugs in patients with non-insulin-dependent diabetes mellitus. Urinary albumin levels decreased in 15 patients with non-insulin-dependent diabetes mellitus who were taking diltiazem during a four-week low-sodium diet but not while eating a higher sodium diet. Dietary sodium did not significantly affect albumin levels when these patients took nifedipine to lower their blood pressure. Urinary excretion of albumin is a sign of mild kidney disease.

Measurement, Physiological aspects, Diabetic nephropathies, Albumin, Salt-free diet, Sodium restricted diet

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