Fabbri A, Cocchi R, Degli Esposti E, Lucatello A, Sturani A, Tampieri G, Fusaroli M
Department of Nephrology and Dialysis S. Maria delle Croci Hospital, Ravenna, Italy.
Nephrol Dial Transplant. 1990;5 Suppl 1:81-3. doi: 10.1093/ndt/5.suppl_1.81.
The antiproteinuric efficacy of angiotensin-converting-enzyme inhibitors (ACEI) has been extensively investigated in patients with several types of nephropathy, but there are few data on the use of ACEI in patients with primary glomerular disease without renal function impairment. We evaluate the effect of long-term therapy with captopril on arterial pressure and proteinuria in 13 patients with primary glomerular disease, selected on the following criteria: persistent proteinuria greater than 600 mg/day, serum creatinine less than or equal to 1.5 mg/dl, no dietary restriction or antihypertensive or immunosuppressive therapy for at least 9 months prior to enrolment. Ten of 13 patients were normotensive. The treatment with captopril induced an early and persistent decrease in proteinuria (41%), and a significant increase in serum albumin. We did not find a significant correlation between changes in MAP and changes in protein loss or between variations in serum creatinine and in proteinuria. Our results demonstrate that captopril is effective in reducing proteinuria in patients with primary glomerular disease with normal renal function. Since the antiproteinuric effect is not associated to a concomitant decrease in arterial pressure, we presume that it might be due to a specific intrarenal action of captopril.
血管紧张素转换酶抑制剂（ACEI）在几种类型肾病患者中的抗蛋白尿疗效已得到广泛研究，但关于ACEI在无肾功能损害的原发性肾小球疾病患者中的应用数据较少。我们评估了卡托普利长期治疗对13例原发性肾小球疾病患者动脉血压和蛋白尿的影响，入选标准如下：持续性蛋白尿大于600 mg/天，血清肌酐小于或等于1.5 mg/dl，入选前至少9个月无饮食限制、未接受抗高血压或免疫抑制治疗。13例患者中有10例血压正常。卡托普利治疗使蛋白尿早期且持续减少（41%），血清白蛋白显著增加。我们未发现平均动脉压变化与蛋白丢失变化之间或血清肌酐变化与蛋白尿变化之间存在显著相关性。我们的结果表明，卡托普利对肾功能正常的原发性肾小球疾病患者减少蛋白尿有效。由于抗蛋白尿作用与动脉压的同时降低无关，我们推测这可能是由于卡托普利的特定肾内作用所致。
