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Related Experiment Videos

Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with

H H Parving1, E Hommel, U M Smidt

  • 1Hvidöre Hospital, Klampenborg, Denmark.

BMJ (Clinical Research Ed.)
|October 29, 1988
PubMed
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Long-term captopril treatment significantly reduced blood pressure and albuminuria in diabetic nephropathy patients. This angiotensin converting enzyme inhibitor also slowed the decline in kidney function, offering protection against diabetic kidney disease progression.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Diabetic nephropathy is a major complication of diabetes mellitus, leading to kidney damage and failure.
  • Hypertension is a common comorbidity in diabetic nephropathy and exacerbates kidney dysfunction.
  • Angiotensin converting enzyme (ACE) inhibitors are known to have renoprotective effects.

Purpose of the Study:

  • To evaluate the long-term effects of ACE inhibition with captopril on kidney function in patients with diabetic nephropathy.
  • To assess the impact of captopril, combined with frusemide or bendrofluazide, on blood pressure and albuminuria in this patient group.

Main Methods:

  • A non-randomized controlled before-after trial was conducted.
  • 18 hypertensive insulin-dependent diabetics with nephropathy received captopril (37.5-100.0 mg daily) plus either frusemide or bendrofluazide for approximately 2.5 years.

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  • A control group of 13 similar patients received no treatment; arterial blood pressure, albuminuria, and glomerular filtration rate were measured.

    • Main Results:

    • The captopril group experienced a significant reduction in mean arterial blood pressure (8.7 mm Hg) compared to controls, who showed an increase (6.6 mm Hg) (p < 0.001).
    • Albumin excretion decreased significantly in the captopril group (to 390 micrograms/min) while rising in controls (to 1367 micrograms/min) (p < 0.001).
    • The rate of decline in glomerular filtration rate was significantly lower in the captopril group (5.8 ml/year) versus controls (10.0 ml/year) (p < 0.01).

    Conclusions:

    • Captopril demonstrates significant renoprotective effects in hypertensive patients with diabetic nephropathy.
    • The drug effectively lowers blood pressure and reduces albuminuria, thereby slowing the progression of kidney disease.
    • Captopril is a valuable therapeutic option for managing hypertension and protecting kidney function in this high-risk population.