Effect of the Angiotensin Converting Enzyme Inhibitor, Captopril (SQ14,225), on Orthostatic Sodium and Water Retention in Patients with Idiopathic Edema

Abstract

Captopril (SQ14,225), an orally administered angiotensin converting enzyme inhibitor, was given to 8 patients with idiopathic edema, in order to study the role of the renin-angiotensin-aldosterone system in orthostatic sodium and water retention. Compared to 5 normal subjects, patients with idiopathic edema showed significantly greater reduction in water and sodium excretion, and greater increment in plasma aldosterone and plasma renin activity, in the upright posture. Captopril significantly restored water and sodium excretion, attenuated the increment in plasma aldosterone, and enhanced the rise in plasma renin activity in patients with idiopathic edema. The effects of captopril on these variables were not remarkable in normal subjects. These results suggest that an enhanced response of the renin-angiotensin-aldosterone system to standing plays an important role in the pathophysiology of idiopathic edema.

Extreme Diuretic Dependence in Idiopathic Edema: Mechanisms, Prevention and Therapy

“…The best prevention of the need for diuretics is a low-salt diet and, where possible, recumbency. When drug treatment becomes unavoidable, converting enzyme inhibitors remain the mainstay of therapy of idiopathic edema [15]. In our experience they are the best initial or diuretics-replacing choice unless low-dose diuretics administered intermittently (e.g.…”

Idiopathic edema: state of the art

“…у 8 пациентов с ИО и 5 здоровых людей. По сравнению со здоровыми людьми у пациентов с ИО отмечалось значительное снижение экскреции мочи и электролитов, а также повышение активности альдостерона и ренина в исходном вертикальном положении без изменения функции почек [9]. Подобные данные были получены и другими исследовательскими группами [10,11] О б з о р л и т е р а т у р ы как не проводилось исследований, направленных на изучение влияния положения тела на выведение воды и солей у нормально гидратированных пациентов, на стандартизированной диете, которые не принимали бы мочегонные или слабительные препараты, абсолютного подтверждения данной теории в настоящее время не существует.…”

Effectiveness of Human Atrial Natriuretic Peptide Administration in a Patient with Idiopathic Edema

“…Though the disease has been associated with capillary leak [1], refeeding, activation of renin and aldosterone [2, 3], a lack of dopamine [4, 5], the pathophysiologic mechanism has not been elucidated clearly. ANP is thought to have some relationship to idiopathic edema, but only a few clinical studies have addressed the issue [6].…”