Long-term effects of antihypertensive regimens on renal hemodynamics and proteinuria

Kidney Int. 1993 Jun;43(6):1210-8. doi: 10.1038/ki.1993.171.

Abstract

The long-term effects of different antihypertensive regimens were studied in uninephrectomized beagles with alloxan-induced diabetes mellitus. Mean arterial pressure (MAP) was elevated (P < 0.05) in untreated diabetic dogs. Treatment of diabetic dogs with an angiotensin converting enzyme inhibitor (ACEI; lisinopril), a calcium antagonist (CA;TA-3090), or both lowered MAP. At one year, the RBF, GFR, and SNGFR were similarly elevated (P < 0.05) in all groups of diabetic dogs. The increase in SNGFR present in untreated diabetic dogs was primarily attributable to an increased (P < 0.05) glomerular capillary pressure (PGC). Treatment with lisinopril lowered the PGC to a mean value that was indistinguishable from that for nondiabetic dogs. In contrast, diabetic dogs treated with TA-3090 had an elevated PGC. While untreated diabetic dogs exhibited marked increases in glomerular volume (P < 0.05 vs. nondiabetic dogs), treatment with lisinopril and TA-3090, either alone or in combination, blunted the extent of glomerular hypertrophy observed in diabetic dogs (P < 0.05 vs. untreated diabetic dogs). Proteinuria was similarly reduced (P < 0.05 vs. untreated diabetic dogs) in dogs treated with lisinopril and TA-3090. Combination therapy of diabetic dogs produced a further significant (P < 0.05) decrement in proteinuria. We conclude that although treatment of diabetic dogs with either lisinopril or TA-3090 results in differential effects on PGC; each produces a similar decrement in proteinuria. Further, combination therapy has a greater effect on proteinuria than either agent alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • Antihypertensive Agents / therapeutic use*
  • Calcium Channel Blockers / therapeutic use*
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetes Mellitus, Experimental / physiopathology*
  • Diltiazem / administration & dosage
  • Diltiazem / analogs & derivatives*
  • Diltiazem / therapeutic use
  • Dipeptides / administration & dosage
  • Dipeptides / therapeutic use*
  • Dogs
  • Drug Therapy, Combination
  • Female
  • Glomerular Filtration Rate / drug effects
  • Hemodynamics / drug effects
  • Homeostasis
  • Kidney / drug effects*
  • Kidney / physiopathology
  • Lisinopril
  • Male
  • Proteinuria / prevention & control*
  • Renal Circulation / drug effects

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Dipeptides
  • clentiazem
  • Lisinopril
  • Diltiazem