Dworkin L D, Feiner H D, Parker M, Tolbert E
Department of Medicine, New York University Medical Center, New York, New York.
Kidney Int. 1991 Jun;39(6):1112-7. doi: 10.1038/ki.1991.141.
Spontaneously hypertensive rats (SHR) that underwent uninephrectomy (UNX) at six weeks of age were randomly assigned to receive no treatment, the calcium channel blocker, nifedipine, or the angiotensin converting enzyme inhibitor, enalapril. Both drugs reduced systemic blood pressure, however, blood pressure tended to be greater in rats given nifedipine than in those on enalapril. After six months, proteinuria and the relevance of glomerula sclerosis were significantly reduced in the two treated groups compared to values observed in untreated SHR. Kidney weight was also reduced by therapy, suggesting that both enalapril and nifedipine inhibited compensatory kidney growth. Micropuncture studies performed in similarly treated groups of rats, but at 11 weeks of age, revealed that PGC was elevated in untreated UNX SHR and reduced by both nifedipine and enalapril. These findings support the hypothesis that glomerular hypertension and renal hypertrophy are important risk factors for glomerular injury. They suggest that calcium blockers are as effective as angiotensin converting enzyme inhibitors in preventing progressive kidney damage.
6周龄时接受单侧肾切除术（UNX）的自发性高血压大鼠（SHR）被随机分为三组，分别不接受治疗、接受钙通道阻滞剂硝苯地平或血管紧张素转换酶抑制剂依那普利。两种药物均降低了全身血压，然而，服用硝苯地平的大鼠血压往往高于服用依那普利的大鼠。6个月后，与未治疗的SHR相比，两个治疗组的蛋白尿和肾小球硬化相关性显著降低。治疗也使肾脏重量减轻，表明依那普利和硝苯地平均抑制了肾脏的代偿性生长。在11周龄时对类似治疗的大鼠组进行的微穿刺研究表明，未治疗的UNX SHR的肾小球毛细血管静水压（PGC）升高，而硝苯地平和依那普利均可使其降低。这些发现支持了肾小球高血压和肾肥大是肾小球损伤重要危险因素的假说。它们表明钙阻滞剂在预防进行性肾损伤方面与血管紧张素转换酶抑制剂一样有效。
