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Related Experiment Videos

Spirapril in chronic renal failure

G Stein1, B Sierakowski, U Jansa

  • 1Friedrich-Schiller University of Jena, Department of Nephrology, Germany.

Blood Pressure. Supplement
|January 1, 1994
PubMed
Summary

Spirapril effectively lowers blood pressure in hypertensive patients with kidney issues. This study shows it is a safe and effective treatment for essential hypertension, even with impaired renal function.

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Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Essential hypertension is a prevalent condition often coexisting with renal impairment.
  • Managing hypertension in patients with kidney disease requires careful consideration of treatment efficacy and safety.
  • Angiotensin-converting enzyme inhibitors like spirapril are commonly used for hypertension, but their effects on renal function warrant investigation.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of spirapril in patients with mild-to-moderate essential hypertension and varying degrees of renal impairment.
  • To assess the impact of spirapril on renal function, including glomerular filtration rate (GFR) and renal plasma flow (RPF).

Main Methods:

  • A single-blind trial involving 49 hypertensive patients with renal impairment.
  • A 2-week placebo run-in followed by a 4-week treatment with spirapril 6 mg once daily.
  • Renal function assessed via technetium 99m-DTPA clearance (GFR), radioiodine-labelled sodium iodohippurate clearance (RPF), and creatinine clearance (Clcr).

Main Results:

  • Spirapril treatment did not significantly alter GFR or creatinine clearance.
  • Renal plasma flow remained stable in renally impaired patients but increased by approximately 10% in those with normal creatinine clearance.
  • 48% of patients with renal failure and 31% with normal renal function achieved target diastolic blood pressure (< or = 90 mmHg) or a reduction of at least 10 mmHg.

Conclusions:

  • Spirapril (6 mg once daily) is an effective and well-tolerated antihypertensive therapy for patients with mild-to-moderate essential hypertension and renal impairment.
  • The drug demonstrates a favorable renal safety profile, with no significant negative impact on GFR or creatinine clearance.
  • Spirapril contributes to achieving blood pressure control in a significant proportion of hypertensive patients, including those with compromised kidney function.

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