Effects of converting enzyme inhibition on split renal function in renovascular hypertension

Journal Article · Thu May 01 04:00:00 EDT 1986 · Hypertension (Dallas); (United States)

DOI:https://doi.org/10.1161/01.HYP.8.5.415· OSTI ID:5488955

Miyamori, I; Yasuhara, S; Takeda, Y; Koshida, H; Ikeda, M; Nagai, K; Okamoto, H; Morise, T; Takeda, R; Aburano, T

The effects of captopril on effective renal plasma flow and glomerular filtration rate were studied using a noninvasive radioisotopic method on individual kidneys in eight patients with renovascular hypertension and 12 patients with essential hypertension with various renin levels. Four patients with renovascular hypertension had unilateral while three had bilateral renal artery stenosis. The effective renal plasma flow and glomerular filtration rate were determined by using /sup 131/I-iodohippurate sodium and /sup 99m/Tc-diethylenetriamine pentaacetic acid, respectively. Glomerular filtration rate and effective renal plasma flow were significantly reduced in the stenotic kidneys of patients with renovascular hypertension compared with values in nonstenotic kidneys (p less than 0.01). Treatment with captopril, 37.5 to 75 mg/day for 1 to 48 weeks, further reduced the glomerular filtration rate only in stenotic kidneys, and effective renal plasma flow increased in both kidney types. In two of the three renal hypertensive patients with bilateral renal artery stenosis, captopril produced a reversible azotemia that was unrelated to the fall in blood pressure, as evidenced by the lack of azotemia seen after a moderate blood pressure reduction induced by other antihypertensive medications. These results indicate that endogenous angiotensin II is essential in maintaining the glomerular filtration rate in stenotic kidneys and suggest that a reduction in glomerular filtration rate during captopril administration could indicate the presence of renal artery stenosis.

• Research Organization: Kanazawa Univ., Japan
• OSTI ID: 5488955
• Journal Information: Hypertension (Dallas); (United States), Journal Name: Hypertension (Dallas); (United States) Vol. 5; ISSN HPRTD
• Country of Publication: United States
• Language: English

Related Subjects

550901* -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
ADRENAL HORMONES
ALDEHYDES
ALDOSTERONE
AMINES
AMINO ACIDS
ANTIHYPERTENSIVE AGENTS
AZOLES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BLOOD FLOW
BLOOD PRESSURE
BODY
CARBOXYLIC ACIDS
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CHELATING AGENTS
CORTICOSTEROIDS
DAYS LIVING RADIOISOTOPES
DISEASES
DRUGS
DTPA
ENZYME INHIBITORS
ENZYMES
HETEROCYCLIC ACIDS
HETEROCYCLIC COMPOUNDS
HORMONES
HOURS LIVING RADIOISOTOPES
HYDROLASES
HYDROXY COMPOUNDS
HYPERTENSION
INTERMEDIATE MASS NUCLEI
IODINE 131
IODINE ISOTOPES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
KETONES
KIDNEYS
MINERALOCORTICOIDS
NONSPECIFIC PEPTIDASES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATHOGENESIS
PATIENTS
PEPTIDE HYDROLASES
PREGNANES
PROLINE
PYRROLES
PYRROLIDINES
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
RENIN
STEROID HORMONES
STEROIDS
SYMPTOMS
TECHNETIUM 99
TECHNETIUM ISOTOPES
TRACER TECHNIQUES
VASCULAR DISEASES
YEARS LIVING RADIOISOTOPES