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Enalapril improved renal function and proteinuria in chronic glomerulopathies
L F Ferder1, F Inserra, H Daccordi
1Buenos Aires University School of Medicine, Argentina.
Insights
Enalapril therapy shows promise for patients with glomerulonephritis (GN), improving kidney function and reducing proteinuria over time. This treatment may offer a better long-term prognosis for GN patients.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Glomerulopathies (GN) encompass a group of kidney diseases affecting the glomeruli.
- Patients with GN often experience reduced kidney function and significant proteinuria.
- ACE inhibitors like enalapril are used to manage hypertension and proteinuria in kidney disease.
Purpose of the Study:
- To evaluate the efficacy and safety of enalapril in patients with various forms of glomerulonephritis.
- To assess the impact of enalapril on blood pressure, renal function, and proteinuria in GN patients.
Main Methods:
- A study involving ten patients diagnosed with glomerulonephritis (membranoproliferative, membranous, focal/diffuse glomerulosclerosis, poststreptococcal).
- Patients received enalapril (10-40 mg/day), with some also receiving diuretic therapy.
- Regular monitoring of blood pressure, serum creatinine, blood urea nitrogen, creatinine clearance, and 24-hour urinary protein over a mean of 15.9 months.
Main Results:
- Blood pressure was significantly controlled in hypertensive patients.
- Serum creatinine, blood urea nitrogen, creatinine clearance, and 24-hour urinary protein showed improvement.
- No significant changes in serum potassium or adverse clinical events were observed.
Conclusions:
- Enalapril therapy may improve the long-term prognosis for patients with glomerulonephritis.
- The drug appears to maintain glomerular filtration rate and decrease proteinuria.
- Enalapril demonstrates a favorable safety profile in this patient cohort.
Abstract:
Ten patients (6 men, 4 women, age range 35-64 years) with glomerulopathies were studied. Diagnoses were membranoproliferative glomerulonephritis (GN; n = 4), membranous GN (n = 3), focal and diffuse glomerulosclerosis (n = 2), and poststreptococcal GN (n = 1). These were confirmed by renal biopsy in 8 of the 10 patients. All patients had reduced function (creatinine clearance 15-55 ml/min); proteinuria ranged from 1.0 to 10.4 g/day. Three normotensive patients received enalapril 10 mg once daily. Seven hypertensives received enalapril 10-40 mg once daily to control blood pressure (BP). Concomitant diuretic therapy (furosemide/bumetanide) was administered to 6 patients. There were visits every 14 days for a mean of 15.9 months (range 9-26 months). Diet was monitored, and BP was significantly controlled in the hypertensive patients but not altered in the normotensives. Serum creatinine, blood urea nitrogen, creatinine clearance, and 24-hour urinary protein improved and did not deteriorate progressively. Serum potassium did not change significantly. No adverse clinical events were noted. Enalapril therapy may improve the prognosis for GN over time by maintaining glomerular filtration rate and decreasing proteinuria.