Long-term treatment with either enalapril or nitrendipine stabilizes albuminuria and increases glomerular filtration rate in non-insulin-dependent diabetic patients

P. Ruggenenti, L. Mosconi, L. Bianchi, L. Cortesi, M. Campana, G. Pagani, G. Mecca, G. Remuzzi

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Abstract

The effect of short- (98 days) and long-term (1 year) treatment with nitrendipine (10 to 40 mg/d) and enalapril (5 to 20 mg/d) on kidney function was studied prospectively in a parallel group design in 16 microalbuminuric non-insulin-dependent diabetic patients with mild hypertension and biopsy- proven diabetic glomerulopathy. At the end of the short-term treatment period diastolic blood pressure significantly decreased from 95.4 ± 2.5 mm Hg to 83.5 ± 3.5 mm Hg (P <0.001) in the nitrendipine group and from 96.7 ± 2.5 to 86.7 ± 5.6 mm Hg (P <0.001) in the enalapril group. Both overnight urinary albumin excretion rate and albumin fractional clearance tended to increase in the nitrendipine group and to decrease in the enalapril group, whereas the glomerular filtration rate and the renal plasma flow were similar to baseline in both study groups. At the end of the long-term treatment period diastolic blood pressure significantly decreased from 95.4 ± 2.5 mm Hg to 86.0 ± 6 mm Hg (P <0.005) in the nitrendipine group and from 96.7 ± 2.1 to 90.8 ± 4.3 mm Hg (P <0.05) in the enalapril group. Overnight urinary albumin excretion and albumin fractional clearance were similar to baseline in both study groups. The glomerular filtration rate significantly increased from 70.2 ± 14.2 to 96.8 ± 20.4 (P <0.05) in the nitrendipine group and from 58.9 ± 10.7 to 78.5 ± 11.0 (P <0.05) in the enalapril group. The renal plasma flow also significantly increased from 456.6 ± 165.3 to 597.2 ± 178.9 (P <0.01) in the nitrendipine group. Both treatments were well tolerated. Thus, long-term treatment with nitrendipine and enalapril, in addition to controlling blood pressure, prevented urinary albumin excretion from increasing with time and increased the glomerular filtration rate.

Original languageEnglish
Pages (from-to)753-761
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume24
Issue number5
Publication statusPublished - 1994

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Nitrendipine
Enalapril
Albuminuria
Glomerular Filtration Rate
Albumins
Blood Pressure
Renal Plasma Flow
Therapeutics
Hypertension
Kidney
Biopsy

ASJC Scopus subject areas

  • Nephrology

Cite this

Long-term treatment with either enalapril or nitrendipine stabilizes albuminuria and increases glomerular filtration rate in non-insulin-dependent diabetic patients. / Ruggenenti, P.; Mosconi, L.; Bianchi, L.; Cortesi, L.; Campana, M.; Pagani, G.; Mecca, G.; Remuzzi, G.

In: American Journal of Kidney Diseases, Vol. 24, No. 5, 1994, p. 753-761.

Research output: Contribution to journalArticle

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abstract = "The effect of short- (98 days) and long-term (1 year) treatment with nitrendipine (10 to 40 mg/d) and enalapril (5 to 20 mg/d) on kidney function was studied prospectively in a parallel group design in 16 microalbuminuric non-insulin-dependent diabetic patients with mild hypertension and biopsy- proven diabetic glomerulopathy. At the end of the short-term treatment period diastolic blood pressure significantly decreased from 95.4 ± 2.5 mm Hg to 83.5 ± 3.5 mm Hg (P <0.001) in the nitrendipine group and from 96.7 ± 2.5 to 86.7 ± 5.6 mm Hg (P <0.001) in the enalapril group. Both overnight urinary albumin excretion rate and albumin fractional clearance tended to increase in the nitrendipine group and to decrease in the enalapril group, whereas the glomerular filtration rate and the renal plasma flow were similar to baseline in both study groups. At the end of the long-term treatment period diastolic blood pressure significantly decreased from 95.4 ± 2.5 mm Hg to 86.0 ± 6 mm Hg (P <0.005) in the nitrendipine group and from 96.7 ± 2.1 to 90.8 ± 4.3 mm Hg (P <0.05) in the enalapril group. Overnight urinary albumin excretion and albumin fractional clearance were similar to baseline in both study groups. The glomerular filtration rate significantly increased from 70.2 ± 14.2 to 96.8 ± 20.4 (P <0.05) in the nitrendipine group and from 58.9 ± 10.7 to 78.5 ± 11.0 (P <0.05) in the enalapril group. The renal plasma flow also significantly increased from 456.6 ± 165.3 to 597.2 ± 178.9 (P <0.01) in the nitrendipine group. Both treatments were well tolerated. Thus, long-term treatment with nitrendipine and enalapril, in addition to controlling blood pressure, prevented urinary albumin excretion from increasing with time and increased the glomerular filtration rate.",
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T1 - Long-term treatment with either enalapril or nitrendipine stabilizes albuminuria and increases glomerular filtration rate in non-insulin-dependent diabetic patients

AU - Ruggenenti, P.

AU - Mosconi, L.

AU - Bianchi, L.

AU - Cortesi, L.

AU - Campana, M.

AU - Pagani, G.

AU - Mecca, G.

AU - Remuzzi, G.

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