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Systemic and renovascular hypertension.

B Jackson1, L Franze, M Whitty

  • 1University of Melbourne, Department of Medicine, Austin Hospital, Heidelberg, Victoria, Australia.

The Tohoku Journal of Experimental Medicine
|January 1, 1992
PubMed
Summary
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Angiotensin converting enzyme (ACE) inhibitors like enalapril reduced blood pressure and improved kidney function in rat models of renal failure. However, long-term use may cause irreversible kidney damage in certain hypertension types.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Systemic hypertension is a significant factor in chronic kidney disease progression.
  • Understanding the renal effects of antihypertensive treatments is crucial for managing kidney failure.

Purpose of the Study:

  • To investigate the impact of angiotensin converting enzyme (ACE) inhibitor enalapril on renal failure progression in rat models.
  • To compare the effects of ACE inhibitors with calcium channel blockers on renal function and proteinuria.

Main Methods:

  • Utilized rat models: remnant kidney, streptozotocin-induced diabetes, nephrotoxic serum nephritis, and two-kidney one-clip hypertension.
  • Administered enalapril (ACE inhibitor) and calcium channel blockers, monitoring blood pressure, proteinuria, and creatinine clearance.

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  • Assessed long-term effects of enalapril on renal morphology and function, including survival rates.

    • Main Results:

    • Enalapril lowered blood pressure in remnant kidney and diabetic rats, reducing proteinuria and improving creatinine clearance.
    • Calcium channel blockers lowered blood pressure similarly but did not improve proteinuria or glomerular filtration rate.
    • Long-term enalapril treatment in renovascular hypertension models improved survival but led to fibrotic, non-functional kidneys, with no recovery after drug withdrawal.

    Conclusions:

    • ACE inhibitors demonstrate potential intra-renal benefits in slowing renal disease progression, warranting human studies.
    • Irreversible renal damage may occur with ACE inhibitors in specific conditions like renovascular hypertension.