Funck-Brentano C, Chatellier G, Alexandre J M
Br Heart J. 1986 Jun;55(6):596-8. doi: 10.1136/hrt.55.6.596.
A patient with congestive heart failure and moderate renal insufficiency developed severe reversible non-oliguric renal failure while on frusemide and enalapril. Renal failure developed when enalapril was given in the presence of pronounced sodium depletion. When positive sodium balance was restored the plasma creatinine concentration began to fall while angiotensin converting enzyme inhibition remained effective and blood pressure was stable. These observations suggest that the degree of sodium depletion plays an important role in the tendency for angiotensin converting enzyme inhibitors to induce renal failure in patients with congestive heart failure and moderate renal insufficiency. Restoration of a positive sodium balance promotes the recovery of renal function after the combined administration of angiotensin converting enzyme inhibitors and diuretics.
一名患有充血性心力衰竭和中度肾功能不全的患者在服用速尿和依那普利期间发生了严重的可逆性非少尿型肾衰竭。当在明显钠缺乏的情况下给予依那普利时发生了肾衰竭。当恢复正钠平衡时，血浆肌酐浓度开始下降，而血管紧张素转换酶抑制作用仍然有效且血压稳定。这些观察结果表明，钠缺乏的程度在充血性心力衰竭和中度肾功能不全患者中血管紧张素转换酶抑制剂诱发肾衰竭的倾向中起重要作用。恢复正钠平衡可促进血管紧张素转换酶抑制剂和利尿剂联合使用后肾功能的恢复。
