Nephrol Dial Transplant (1996) 11: 673-678
© 1996 European Renal Association-European Dialysis and Transplant Association
research-article
Angiotensin converting enzyme inhibition and chronic cyclosporine-induced renal dysfunction in type 1 diabetes
Département de Néphrologie, Hôpital Necker Paris, France
Correspondence and offprint requests to: Correspondence and offprint requests to: Prof. T. Hannedouche, Département de Néphrologie, Hôpitaux Universitaires de Strasbourg, BP 426, 67091 Strasbourg, France
AIM.: This study was designed to evaluate whether the angiotensin converting enzyme inhibitor enalapril could prevent cyclosporine-induced renal dysfunction in diabetic patients treated with CsA in monotherapy.
DESIGN.: Twenty-four recent onset insulin-dependent diabetic patients without prior renal involvement were randomized to receive a 3 month course of either cyclosporine (CsA) alone (7.5 mg/kg. b.i.d. in olive oil) or CsA$enalapril (20 mg p.o. oad.).
END POINTS.: were mean arterial pressure, plasma creatinine, GFR, renal plasma flow, renal vascular resistance, sodium and lithium clearances measured before and after 3 months of treatment.
RESULTS.: Baseline values were identical in both groups except for mean arterial pressure which was slightly higher in the subjects subsequently receiving CsA$enalapril. Three month treatment with CsA increased significantly mean arterial pressure and renal vascular resistance by 9 and 24% respectively, while decreasing significantly glomerular filtration rate and renal plasma flow by 17 and 14% respectively. Enalapril was able to prevent the decline in GFR and the increase in blood pressure induced by CsA. This effect was demonstrated despite a similar increase in renal vascular resistance suggesting a dissociation between changes in glomerular filtration rate and renal vascular resistance during angiotensin converting-enzyme inhibition.
CONCLUSION.: Chronic angiotensin converting-enzyme inhibition could afford some degree of protection against CsA-induced renal dysfunction. Whether these results can be extrapolated to transplant recipients in whom CsA is usually associated to treatment by glucocorticosteroids, deserves further evaluation.
Keywords: cyclosporine A; diabetes mellitus; glomerular filtration rate; renal haemodynamics; kidney tubule; lithium clearance; angiotensin converting enzyme inhibition
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Naesens, D. R. J. Kuypers, and M. Sarwal Calcineurin Inhibitor Nephrotoxicity Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 481 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-S. Wu, C.-W. Yang, C.-T. Chang, M. Bens, and A. Vandewalle Cyclosporin increases the density of angiotensin II subtype 1 (AT1) receptors in mouse medullary thick ascending limb cells Nephrol. Dial. Transplant., August 1, 2003; 18(8): 1458 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-S. Wu, C.-W. Yang, C.-T. Chang, M. Bens, and A. Vandewalle Cyclosporin increases the density of angiotensin II subtype 1 (AT1) receptors in mouse medullary thick ascending limb cells Nephrol. Dial. Transplant., August 1, 2003; 18(88): 1458 - 1465. [Abstract] [Full Text]
|
|