 |
|
Angiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Chronic Renal Disease
Pieter M. ter Wee, MD;
Murray Epstein, MD
Arch Intern Med. 1993;153(15):1749-1759.
Abstract
In recent years, considerable attention has focused on the possibility that some classes of antihypertensive agents may confer a greater renoprotective effect in retarding the progression of chronic renal insufficiency. Experimental studies in rats have demonstrated that the sustained increase in glomerular capillary pressure evoked in response to loss of renal mass produces a destructive sclerosing reaction. Administration of angiotensin-converting enzyme inhibitors decreases glomerular capillary pressure with a resultant reduction of glomerular sclerosis, suggesting that angiotensin-converting enzyme inhibitor therapy may protect the injured kidney from hemodynamically mediated glomerular damage. On the basis of these experimental observations, many studies have attempted to investigate whether angiotensin-converting enzyme inhibitors can slow the progression of chronic renal disease in humans. We surveyed the literature critically and concluded that, the data from animals notwithstanding, the majority of studies in humans have been nonrandomized, of too short duration, or confounded by investigative difficulties. Therefore, we cannot yet conclude that angiotensin-converting enzyme inhibitors modify the rate at which renal disease progresses in nondiabetic patients.
(Arch Intern Med. 1993;153:1749-1759)
Author Affiliations
From the Nephrology Section, Department of Veterans Affairs Medical Center, Miami, Fla, and Division of Nephrology, University of Miami School of Medicine.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Acute and long-term effects of ACE inhibition on renal haemodynamics in glomerular and interstitial nephropathies
Guidi et al.
Journal of Renin-Angiotensin-Aldosterone System 2002;3:40-45.
ABSTRACT
Current Strategies for Management of Hypertensive Renal Disease
Moore et al.
Arch Intern Med 1999;159:23-28.
ABSTRACT
| FULL TEXT
Newer Approaches to Antihypertensive Therapy: Use of Fixed-Dose Combination Therapy
Epstein and Bakris
Arch Intern Med 1996;156:1969-1978.
ABSTRACT
Effects of Calcium Antagonists on Renal Hemodynamics and Progression of Nondiabetic Chronic Renal Disease
ter Wee et al.
Arch Intern Med 1994;154:1185-1202.
ABSTRACT
|
