Effect of captopril on kidney function in insulin-dependent diabetic patients with nephropathy.

Hommel, Eva; Parving, Hans‐Henrik; Mathiesen, Elisabeth R.; Edsberg, Berit; Nielsen, Meta Damkjær; Giese, J.

doi:10.1136/bmj.293.6545.467

Cited by 315 publications

(88 citation statements)

References 29 publications

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“…In our hands this method has a coefficient of variation of 2.8% for GFR [6]. The coefficient of variation for extracellular fluid volume in 11 subjects with diabetic nephropathy was 7.5%.…”

Section: Methodsmentioning

confidence: 62%

“…GFR and extracellular fluid volume were determined from the total 5tCr-EDTA plasma clearance as previously described [6]. In our hands this method has a coefficient of variation of 2.8% for GFR [6].…”

Section: Methodsmentioning

confidence: 99%

“…All patients received at least two daily injections of insulin. Diabetic nephropathy was diagnosed clinically according to previously described criteria [6]. Seven healthy subjects served as a control group.…”

Section: Subjectsmentioning

confidence: 99%

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Effects of acetazolamide on kidney function in Type 1 (insulin-dependent) diabetic patients with diabetic nephropathy

Skøtt

Hommel²,

Bruun

et al. 1988

Diabetologia

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Summary. We investigated the effects of 3 days treatment with acetazolamide 250 mg three times daily on kidney function in 8 Type 1 (insulin-dependent) diabetic patients with nephropathy, and in 7 healthy subjects in a doubleblind placebo controlled cross-over study. Glomerular filtration rate and extracellular fluid volume were measured with the single injection 5tCr-EDTA technique and fluid flow rate from the proximal tubules was determined by measurement of the renal lithium clearance. A 24% decline in glomerular filtration rate was observed in both groups during acetazolamide treatment (control subjects: 108 + 11 vs 82 + 9 ml/min, p<0.02, diabetic patients: 71-+19 vs 54+14ml/min, p <0.01). The renal lithium clearance (ml/min) remained about the same (control subjects: 22 -+ 6 vs 27 + 8, NS, diabetic patients: 14_+ 5 vs 15 + 4, NS). Absolute proximal tubular reabsorption of water (ml/min) was reduced by about onethird (control subjects: 85+11 vs 56-+7, p<0.02, diabetic patients: 55 + 17 vs 37+ 6, p < 0.02), and fractional proximal reabsorption of water and sodium (%) declined (control subjects: 79 + 5 vs 67_+ 8, p <0.02, diabetic patients: 79 + 5 vs 72_+ 6, p < 0.02). Renal sodium clearance and distal fractional reabsorption of sodium was unclmnged. Extracellular fluid volume declined by 10% in both groups (p<0.02). Albuminuria and fractional albumin clearance decreased significantly in the nephropathic patients (p < 0.02). Our study suggests that the effects of acetazolamide on kidney function are similar in healthy subjects and patients with diabetic nephropathy.

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“…In our hands this method has a coefficient of variation of 2.8% for GFR [6]. The coefficient of variation for extracellular fluid volume in 11 subjects with diabetic nephropathy was 7.5%.…”

Section: Methodsmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Effects of acetazolamide on kidney function in Type 1 (insulin-dependent) diabetic patients with diabetic nephropathy

Skøtt

Hommel²,

Bruun

et al. 1988

Diabetologia

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show abstract

“…Hypertension is often associated with diabetic nephropathy [2], and effective antihypertensive treatment has proven to be effective in slowing the progression rate of nephropathy [3][4][5]. Recent studies in patients with diabetic nephropathy suggest that the use of angiotensin converting enzyme (ACE) inhibitors may possess specific advantages in decreasing proteinuria and slowing progression of nephropathy [6][7][8][9]. Nevertheless, whether such renal effects can be seen only with ACE inhibitors or whether ACE inhibitors have more beneficial renal effects as compared to other conventional antihypertensive drugs is uncertain.…”

mentioning

confidence: 99%

Comparison of the renal effects of angiotensin converting enzyme inhibitor and calcium antagonist in hypertensive Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria: a randomised controlled trial

1989

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Summary. Seven of eight hypertensive Type 2 (non-insulindependent) diabetic patients with microalbuminuria completed a randomised crossover trial to compare the renal effects of angiotensin converting enzyme inhibitor (enalapril) and calcium antagonist (nicardipine). Four-week fixed oral maintenance dosages of enalapril (10-20 rag/day) and nicardipine (60-120 rag/day) significantly (p<0.05) lowered the systolic and diastolic blood pressures without altering renal blood flow, glomerular filtration rate and filtration fraction. Both drugs significantly reduced (p< 0.05) urinary albumin excretion rate and fractional clearance of albumin to similar extents. Total renal vascular resistance decreased significantly by nicardipine (p<0.05) and non-significantly by enalapril. Plasma osmotic pressure, plasma aldosterone concentration, total serum protein concentration, serum electrolytes and HbAlc remained unchanged by these drugs, whereas plasma renin activity was significantly higher (/7<0.05) in the enalapril than in the control and nicardipine phases. These results suggest that both drugs have similar renal function preserving effects with a concomitant hypotensive action in hypertensive Type 2 diabetic patients with microalbuminuria, and that the angiotensin converting enzyme inhibitor may not have advantageous renal effects when compared to the calcium antagonist and vice versa. Both drugs might be useful for treatment of high blood pressure in hypertensive diabetic patients, if long-term studies of these drugs can be shown to benefit the patients over other conventional antihypertensive therapies.

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“…Indeed, PG synthesis is augmented in glomeruli isolated from diabetic rats induced by streptozotocin (STZ), an animal model for type 1 diabetes (8) and in mesangial cells cultured under high-glucose concentrations (9 -11). Overproduction of PGE2 has especially been shown to be associated with increased GFR in the early stages of diabetic nephropathy (11)(12)(13)(14), suggesting a pathogenic role in hemodynamic alterations. Aspirin as well as indomethacin, a nonselective inhibitor of PG synthase or cyclooxygenase (COX) that inhibits the synthesis of PGE2 together with other PGs, was reported to cause partial amelioration in STZ-induced diabetic rats (11)(12)(13) or in diabetic patients with nephropathy (14).…”

mentioning

confidence: 99%

Prevention of Diabetic Nephropathy in Rats by Prostaglandin E Receptor EP1-Selective Antagonist

Makino¹,

Tanaka²,

Mukoyama³

et al. 2002

Journal of the American Society of Nephrology

107

100

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Abstract. Local production of prostaglandins (PGs) in the kidney is increased in clinical and experimental diabetic nephropathy, but the role of PGs in the pathogenesis and progression of diabetic nephropathy has remained unclear. It is here shown that an orally active antagonist selective for the PGE receptor EP1 subtype potently prevents the progression of nephropathy in streptozotocin-induced diabetic rats. The effects are shown by ameliorated renal and glomerular hypertrophy, decreased mesangial expansion, inhibited transcriptional activation of transforming growth factor-␤ (TGF-␤) and fibronectin, and complete suppression of proteinuria. In vitro, this agent completely inhibits TGF-␤ and fibronectin upregulation in mesangial cells cultured under high-glucose conditions. These data indicate that the PGE2-EP1 system plays a crucial role in the development of diabetic renal injury in rats. It is further shown that both the EP1 antagonist and aspirin, a nonselective PG synthase inhibitor, markedly attenuate mesangial expansion, whereas only the EP1 antagonist inhibits glomerular hypertrophy and proteinuria, which suggests that these changes are caused by different mechanisms. This study reveals a potential usefulness of selective EP1 blockade as a novel therapeutic strategy for diabetic nephropathy and also brings a new insight into our understanding of this disease.

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Effect of captopril on kidney function in insulin-dependent diabetic patients with nephropathy.

Cited by 315 publications

References 29 publications

Effects of acetazolamide on kidney function in Type 1 (insulin-dependent) diabetic patients with diabetic nephropathy

Effects of acetazolamide on kidney function in Type 1 (insulin-dependent) diabetic patients with diabetic nephropathy

Comparison of the renal effects of angiotensin converting enzyme inhibitor and calcium antagonist in hypertensive Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria: a randomised controlled trial

Prevention of Diabetic Nephropathy in Rats by Prostaglandin E Receptor EP1-Selective Antagonist

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