Linas S
Department of Medicine, University of Colorado Health Sciences Center, Denver.
Am J Kidney Dis. 1990 Oct;16(4 Suppl 1):15-9.
Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers are two classes of antihypertensive agents with novel effects on renal function. In both experimental and clinical studies, calcium channel blockers tend to increase renal blood flow, glomerular filtration rate, and urinary sodium excretion in essential hypertension. ACE inhibitors have similar effects on renal blood flow and glomerular filtration rate in essential hypertension, but they tend to cause sodium retention. ACE inhibitors can cause marked reductions in glomerular filtration rate in renovascular hypertension, making them a problematic choice for the treatment of this form of hypertension. In chronic, progressive renal diseases, ACE inhibitors have been shown to decrease protein excretion and morphologic evidence of glomerulosclerosis. The relationship of the decrease in protein excretion to the progression of renal disease has not yet been established.
血管紧张素转换酶（ACE）抑制剂和钙通道阻滞剂是两类对肾功能有新作用的抗高血压药物。在实验研究和临床研究中，钙通道阻滞剂往往会增加原发性高血压患者的肾血流量、肾小球滤过率和尿钠排泄。ACE抑制剂对原发性高血压患者的肾血流量和肾小球滤过率有类似作用，但它们往往会导致钠潴留。ACE抑制剂可使肾血管性高血压患者的肾小球滤过率显著降低，这使得它们成为治疗这种高血压形式的一个有问题的选择。在慢性进行性肾脏疾病中，ACE抑制剂已被证明可减少蛋白质排泄和肾小球硬化的形态学证据。蛋白质排泄减少与肾脏疾病进展之间的关系尚未确立。
