Rasmussen S, Ibsen H, Giese J
Scand J Urol Nephrol. 1985;19(1):45-8. doi: 10.3109/00365598509180221.
During treatment with the angiotensin converting enzyme inhibitor, Captopril, glomerular filtration rate (GFR) decreased in three unilaterally nephrectomized hypertensive patients with a poorly functioning remaining kidney. The fall in GFR was not related to changes in the blood pressure, and was reversed when Captopril was stopped. In a fourth nephrectomized patient the initially normal GFR was not affected by captopril. These observations point to a functional reduction in GFR due to a withdrawal of an intrarenal action of angiotensin II. Maintenance of GFR may become critically dependent on a functioning renin-angiotensin system when renal perfusion pressure is reduced to a certain degree. Inhibition of angiotensin II formation may lead to a decrease in GFR in patients with renal hypertension and pre-existing renal insufficiency.
在使用血管紧张素转换酶抑制剂卡托普利治疗期间，三名单侧肾切除的高血压患者，其剩余肾脏功能不佳，肾小球滤过率（GFR）下降。GFR的下降与血压变化无关，停用卡托普利后GFR恢复正常。在第四名肾切除患者中，最初正常的GFR不受卡托普利影响。这些观察结果表明，由于血管紧张素II的肾内作用减弱，导致GFR功能性降低。当肾灌注压降低到一定程度时，GFR的维持可能严重依赖于正常运作的肾素-血管紧张素系统。抑制血管紧张素II的形成可能导致肾性高血压且已有肾功能不全的患者GFR下降。
