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Effects of enalaprilat on the renin-angiotensin-aldosterone system and on renal function during CO2 pneumoperitoneum
Marcelo Rodrigues Borba1, Roberto Iglesias Lopes, Murilo Carmona
1Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
Background And Purpose:
Mechanical and hormonal factors have been implicated in pneumoperitoneum-induced renal alterations. The aim of this study was to evaluate the effects of enalaprilat (Vasotec) administration on renal function during CO2 pneumoperitoneum, given that this drug, which is an angiotensin-converting enzyme inhibitor, by inhibiting the renin-angiotensin-aldosterone system, alters hormone-induced changes during pneumoperitoneum.
Materials And Methods:
Thirty adult dogs were randomly assigned to one of three groups (N = 10 each): group A (pneumoperitoneum not performed); group B (CO2 + enalaprilat); group C CO2 only. The groups were analyzed with consideration for body weight, hematologic values, hemodynamic parameters, and renal function (plasma renin activity, urinary debt, creatinine clearance, and sodium-excretory fraction).
Results:
Hemodynamic and acid-basic parameter differences did not influence renal function. Plasma renin activity decreased significantly in group B compared with group C and stayed close to the values in group A. Creatinine clearance remained constant in group B, while in group C, creatinine clearance dropped, and this difference was statistically significant. Urinary debt and sodium-excretory fraction increased in group B during pneumoperitoneum and 60 minutes after this period in comparison with the other groups without reaching statistical significance.
Conclusion:
The decline in urinary debt and in creatinine clearance observed during pneumoperitoneum was less accentuated with administration of enalaprilat.
