Abu-Romeh S H, Nawaz M K, Ali J H, Al-Suhaili A R, Abu-Jayyab A K
Department of Internal Medicine, Faculty of Medicine, Kuwait University.
Clin Nephrol. 1989 Jan;31(1):18-21.
The short-term effect (2 weeks) of angiotensin-converting enzyme inhibitor (enalapril) on renal hemodynamics and urinary albumin excretion was investigated in eleven normotensive patients with incipient diabetic nephropathy (IDN). Six patients had had elevated baseline glomerular filtration rate (GFR) and each responded to enalapril with a decline in the GFR, from a mean of 160.7 to 134 ml/min/1.73 m2, (p less than 0.05). Their respective filtration fraction values also decreased from a mean of 27.8 to 23.8% (p less than 0.01). Such renal hemodynamic change was accompanied by a decrease in urinary albumin excretion (33 to 19 micrograms/min, p less than 0.05). The remaining 5 patients had displayed normal baseline GFR (mean, 109.6 ml/min/1.73 m2), responded to enalapril with minimal change in the GFR (115.2 ml/min/1.73 m2) and showed no significant improvement in their microalbuminuria. It is concluded that enalapril is effective in lowering glomerular filtration pressure and ameliorating microalbuminuria in the normotensive patient with IDN only when the baseline GFR is elevated.
在11例早期糖尿病肾病（IDN）的血压正常患者中，研究了血管紧张素转换酶抑制剂（依那普利）对肾脏血流动力学和尿白蛋白排泄的短期影响（2周）。6例患者基线肾小球滤过率（GFR）升高，每例患者对依那普利的反应均为GFR下降，从平均160.7降至134 ml/min/1.73 m2（p<0.05）。他们各自的滤过分数值也从平均27.8%降至23.8%（p<0.01）。这种肾脏血流动力学变化伴随着尿白蛋白排泄减少（从33降至19微克/分钟，p<0.05）。其余5例患者基线GFR正常（平均109.6 ml/min/1.73 m2），对依那普利的反应是GFR变化极小（115.2 ml/min/1.73 m2），且微量白蛋白尿无显著改善。结论是，仅当基线GFR升高时，依那普利才对血压正常的IDN患者降低肾小球滤过压和改善微量白蛋白尿有效。
