The effect of angiotensin-converting enzyme inhibitors on the progression of nondiabetic renal disease: a pooled analysis of individual-patient data from 11 randomized, controlled trials

Article Abstract:

ACE inhibitors may be beneficial in patients with end-stage kidney disease even if they don't have diabetes. ACE inhibitors can slow the progression of kidney disease in diabetics, but this is the first time they have been evaluated in non-diabetics with kidney disease.

Editorial

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Reversible renal failure associated with angiotensin-converting enzyme inhibitors in polycystic kidney disease

Article Abstract:

Autosomal-dominant polycystic kidney disease (ADPKD) is an inherited disease of the kidney in which hypertension (high blood pressure) precedes the characteristic loss of kidney function in between 50 and 75 percent of the patients diagnosed with the condition. Evidence suggests that impaired blood flow to the kidney caused by cyst growth causes activation of the renin-angiotensin system (a kidney hormone system involved with the maintenance of fluid balance and blood pressure), resulting in increased blood pressure. Hence, angiotensin-converting enzyme (ACE) inhibitors, a widely used class of antihypertensive medication, have been reported to be extremely effective in the treatment of ADPKD-related hypertension. In patients with massive cyst infiltration of the kidney, ACE-inhibitor treatment may adversely affect kidney function. Eight instances are reported of reversible acute kidney deterioration in five patients with ADPKD, massive kidney involvement, and chronic renal (kidney) insufficiency during ACE-inhibitor treatment for hypertension. Patients were both men and women, ranging in age from 32 to 78 years; in all cases ACE-inhibitor therapy either predisposed the patient to or precipitated the acute event. Two of the patients who experienced renal failure during ACE-inhibitor treatment experienced a recurrence of the failure when an attempt was made to reintroduce treatment with the same drugs. Hence, patients with ADPKD-related hypertension who have compromised kidney function or extensive cystic involvement of the kidney are at risk for adverse effects of ACE inhibitor treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Polycystic kidney disease

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The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin dependent diabetes and hypertension

Article Abstract:

The risk of heart attack may be greater in patients with high blood pressure and diabetes treated with nisoldipine compared to those treated with enalapril. Researchers compared nisoldipine, a calcium-channel blocker, and enalapril, an angiotensin-converting enzyme (ACE) inhibitor, in 470 men with hypertension and diabetes. More patients taking nisoldipine had heart attacks during the five years they were studied. Other measures of cardiovascular risk were more favorable in patients taking nisoldipine. Additional research is necessary to confirm this finding.

Product/Service Evaluation, Hypertension, Enalapril, Calcium channel blockers, Sular (Medication)

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