Reams G P, Bauer J H
Department of Medicine, University of Missouri School of Medicine, Columbia.
Am J Kidney Dis. 1988 Jun;11(6):499-507. doi: 10.1016/s0272-6386(88)80086-6.
Nineteen essential hypertensive patients were entered into a protocol to assess the BP, humoral and renal effects of the angiotensin converting enzyme inhibitor, lisinopril (MK 521, 20 to 80 mg once daily), administered for 52 weeks. Specifically monitored prior to, and following 12 and 52 weeks of lisinopril monotherapy were plasma renin activity and plasma aldosterone, the clearances of creatinine, inulin and para-aminohippurate, and the 24-hour urinary excretion of protein. BP was well controlled. Plasma renin activity was stimulated, and plasma aldosterone was suppressed throughout the entire protocol. In contrast to the reported short-term and long-term renal effects of enalapril, lisinopril (a lysine analog of enalapril) had no short-term effect on renal function: glomerular filtration rate, effective renal plasma flow, filtration fraction (FF), renal vascular resistance (RVR), and protein excretion were all unchanged. However, following long-term therapy, both FF and RVR were decreased. Lisinopril appears to convey no specific renal pharmacological benefit.
19名原发性高血压患者参与了一项研究方案，以评估血管紧张素转换酶抑制剂赖诺普利（MK 521，每日一次，20至80毫克）治疗52周对血压、体液和肾脏的影响。在赖诺普利单药治疗12周和52周之前及之后，具体监测了血浆肾素活性、血浆醛固酮、肌酐清除率、菊粉清除率和对氨基马尿酸清除率，以及24小时尿蛋白排泄量。血压得到了良好控制。在整个研究方案中，血浆肾素活性受到刺激，血浆醛固酮受到抑制。与依那普利已报道的短期和长期肾脏影响不同，赖诺普利（依那普利的赖氨酸类似物）对肾功能没有短期影响：肾小球滤过率、有效肾血浆流量、滤过分数（FF）、肾血管阻力（RVR）和蛋白排泄均未改变。然而，长期治疗后，FF和RVR均降低。赖诺普利似乎没有带来特定的肾脏药理学益处。
