Related Experiment Videos
Improved kidney function with cilazapril in hypertensive type II diabetics with chronic renal failure
M Bursztyn1, I Kobrin, J Fidel
1Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Insights
Cilazapril, an ACE inhibitor, effectively lowered blood pressure and improved kidney function in hypertensive diabetics with renal insufficiency. The treatment enhanced renal function, particularly in patients with less significant blood pressure changes.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Hypertension and diabetes mellitus are leading causes of chronic kidney disease.
- Diabetic nephropathy is a significant complication, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of cilazapril in hypertensive type II diabetics with renal insufficiency.
- To assess the impact of cilazapril on blood pressure and renal function parameters.
Main Methods:
- A study involving 15 type II diabetic patients with hypertension and chronic renal insufficiency.
- Treatment with cilazapril for 8 weeks after a 2-week placebo period.
- Monitoring of blood pressure, serum creatinine, creatinine clearance, and urinary protein excretion.
Main Results:
- Cilazapril significantly reduced blood pressure (176/105 to 164/95 mm Hg).
- Renal function improved, indicated by increased creatinine clearance (41.6 to 47.4 ml/min) and decreased protein excretion (0.8 to 0.5 g/24 h).
- Blood pressure reduction was inversely correlated with creatinine clearance improvement.
Conclusions:
- Cilazapril demonstrates efficacy in improving both blood pressure control and renal function in hypertensive diabetics with renal insufficiency.
- The drug is safe for this high-risk patient population.
- Renal function benefits were most pronounced in patients with the least blood pressure reduction, suggesting a complex interplay.
Abstract:
The purpose of this study was to determine efficacy and safety of the angiotensin converting enzyme inhibitor, cilazapril, in the treatment of hypertensive diabetics with renal insufficiency. Fifteen type II diabetics with hypertension and chronic renal insufficiency aged (mean +/- SD) 64 +/- 7 years were studied in a regional clinic and university hospital hypertension unit. The blood pressure was measured biweekly. Urinary collections were done after 2 weeks of placebo and 8 weeks of cilazapril treatment. The blood pressure decreased from 176 +/- 15/105 +/- 9 to 164 +/- 11/95 +/- 9 mm Hg and serum creatinine from 197 +/- 69 to 179 +/- 73 mumol/L. The creatinine clearance rose from 41.6 +/- 11.4 to 47.4 +/- 14.9 ml/min, while protein excretion decreased from 0.8 +/- 1.3 to 0.5 +/- 0.8 g/24 h (p less than 0.05). The blood pressure change was inversely correlated with the creatinine clearance change (r = -0.5, n = 15, p less than 0.05). In these high-risk patients, 8 weeks of cilazapril treatment improved both blood pressure control and renal function but renal function improved most in the patients whose blood pressure changed the least.