Which urinary proteins are decreased after angiotensin converting--enzyme inhibition?

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E Guidi1, A Giglioni, M G Cozzi

  • 1Centro di Ricerca Clinica in Nefrologia e Ipertensine Arteriosa Unità Operativa di Nefrologia Dialisi e Trapianto, Milano, Italy.

Renal Failure
|May 9, 1998
PubMed

Insights

Angiotensin converting-enzyme (ACE) inhibitors reduced both albumin and Tamm-Horsfall Glycoprotein (THGP) excretion in hypertensive patients. This suggests ACE inhibitors may impact renal tubular cells, not just glomerular hemodynamics.

Area of Science:

  • Nephrology
  • Pharmacology
  • Biochemistry

Background:

  • Angiotensin converting-enzyme (ACE) inhibitors are thought to reduce proteinuria by altering glomerular hemodynamics.
  • This mechanism implies that urinary excretion of tubular proteins should remain unchanged following ACE inhibition.

Purpose of the Study:

  • To investigate the effect of ACE inhibition on the urinary excretion of albumin and Tamm-Horsfall Glycoprotein (THGP).
  • To determine if ACE inhibitors have effects beyond glomerular hemodynamics, potentially at the renal tubular level.

Main Methods:

  • A study involving 15 essential hypertensive patients after a 4-week drug washout period.
  • Patients received oral Quinapril for 2 months, with urinary protein excretion measured before and after treatment.
  • Urinary protein levels were analyzed using SDS polyacrylamide gel electrophoresis and silver staining (Phast System).

Main Results:

  • After 2 months of ACE inhibition, plasma ACE activity significantly decreased (p = 0.0001).
  • Urinary excretion of both albumin and THGP significantly decreased (p = 0.05 and p = 0.02, respectively).
  • No significant changes were observed in blood pressure, body weight, or creatinine clearance.

Conclusions:

  • The observed reduction in THGP excretion, a protein solely secreted by renal tubules, is unexpected.
  • These findings suggest that ACE inhibitors may exert effects directly on renal tubular cells, in addition to their known impact on glomerular hemodynamics.

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