Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Captopril, a competitive antagonist of angiotensin converting enzyme, has been marketed in the United States for the treatment of resistant hypertension. Despite extensive study, its exact mechanism of action remains unclear; decreased renin-angiotensin-aldosterone and sympathoadrenal system activity as well as increased bradykinin and prostaglandin E and F activity have been postulated. The drug decreases peripheral vascular resistance. Controlled trials in resistant hypertension of various etiologies and chronic congestive heart failure have demonstrated sustained effectiveness and therapeutic benefits. Side effects include skin rash, loss of taste, proteinuria, and leukopenia; higher doses and concomitant renal dysfunction appear to be predisposing factors. The benefit-to-risk ratio for captopril clearly justifies its use in resistant cases of hypertension and congestive heart failure, but further experience is needed to evaluate its use in milder forms of these diseases.
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PMID:Captopril: clinical pharmacology and benefit-to-risk ratio in hypertension and congestive heart failure. 676 88

The effects of Captopril on blood pressure and renal function were evaluated in ten patients with different degrees of hypertension. In seven, blood pressure was reduced after 7 weeks of therapy; in three it remained practically unchanged. No correlation was found between the standing plasma renin activity before treatment and the hypotensive response. Plasma renin activity increased significantly from the median value of 5.4 (range 1-16.7) to 9.5 (range 2.6-19.8) ng ml-1 h-1 (P less than 0.05) and urine aldosterone significantly fell from 13 (range 2.3-52.5) to 7.4 (range 1.6-14) microgram 24 h-1 (P less than 0.01) during therapy. Renal plasma flow decreased from 534 (range 300-616) to 471 (range 333-606) ml min-1, but the difference was not significant, and glomerular filtration rate fell significantly form 122 (range 64-143) to 88 (range 71-116) ml min-1 (P less than 0.05). No urinary excretion of alpha 2-macroglobulin was observed during Captopril. 24 h proteinuria, albumin and transferrin clearance, alanine-amino transferase, gammaglutamyl transferase and alpha glucosidase excretion rate and malate-dehydrogenase clearance remained unaltered throughout the treatment. This indicates that neither glomerular permeability nor renal tubular function were affected by the drug.
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PMID:Hypotensive and renal effects of captopril. 680 Aug 13

The antihypertensive effects of the oral converting enzyme inhibitor captopril and of propranolol were evaluated in a single-blind trial of 12 weeks in 19 ambulatory men with moderated essential hypertension (supine diastolic blood pressure [DPB], 100 to 120 mm Hg after receiving placebo for two weeks) whose sodium intake was unrestricted. The captopril group included 12 patients and the propranolol group seven. After the initial dose-finding period of four weeks, supine DBP was significantly reduced in eight patients receiving captopril and in four of the patients receiving propranolol. In these patients DBP decreased throughout the following eight weeks. In the remaining patients from each group, DBP was not reduced by either drug given alone at maximum allowable dosages during dose-finding periods, nor by combined administration in following weeks. No adverse side effects attributable to captopril were noted, except in one patient in whom proteinuria developed after seven weeks. Captopril has potential value in the treatment of moderate essential hypertension.
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PMID:Comparison of antihypertensive effects of captopril and propranolol in essential hypertension. 700 74

Captopril (SQ 14 225), an orally active inhibitor of angiotensin converting enzyme, was evaluated in the treatment of primary (essential) hypertension in a placebo-controlled long-term study. In 24 patients allocated to captopril treatment, mean supine BP fell from 174 +/- 18/110 +/- 7 to 151 +/- 22/96 +/- 12 mmHg. Ten patients achieved a supine diastolic BP of less than or equally 90 mmHg with a mean BP fall of 28/22 mmHg after 4 weeks' captopril dose titration (75-450 mg daily). In 14 patients, BP fell 19/9 mmHg. When hydrochlorothiazide (50-100 mg daily) was subsequently added, a total supine BP reduction of 51/20 mmHg was noted. In the placebo control group (n = 16), BP changed +1/-2 mmHg from 171/110 mmHg while addition of hydrochlorothiazide caused a mean supine BP fall of 19/10 mmHg. During long-term follow-up (mean 11.8 months), no resistance to therapy developed. A weak correlation, (p less than 0.05) was seen between pretreatment plasma renin activity and initial captopril-induced BP reduction. However, in patients with clearly defined low renin hypertension, the hypotensive effect of captopril was much less than in patients with higher renin values. Captopril induced a significant decrease in urinary aldosterone excretion, which was partially reversed by addition of hydrochlorothiazide. Observed side-effects were proteinuria (1 case), rash (2 cases) and taste disturbances (3 cases). During long-term follow-up, seven patients have dropped out, four due to side-effects and three because of non-compliance.
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PMID:Captopril, an orally active converting enzyme inhibitor, in the treatment of primary hypertension. A controlled long-term study with reference to initial plasma renin activity. 701 95

We report the use of the orally active converting enzyme inhibitor Captopril in hypertensive patients with mild chronic renal failure. Twenty eight patients were followed for a period of six months. Eleven patients required the addition of furosemide. Mean arterial pressure (MAP) decreased in all but two at six months (MAP: 102 +/- 0.8 vs 133 +/- 2.2mmHg, p less than 0.001). Untoward effects were frequent: the commonest reactions are loss of taste (four patients), skin rashes (11 patients), proteinuria (2 patients), tachycardia (2 cases). These side effects disappeared after reduction of dose (10 cases) or withdrawal (8 cases). Patients on 300mg daily or less were free of any untoward effect. In summary (i) Captopril alone or in combination with furosemide has an antihypertensive effect in patients with chronic renal failure and hypertension; (ii) side effects seem to be dose dependant and a reduced dosage should be used in these patients.
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PMID:Long term effect of captopril in hypertension with chronic renal failure. 701 4

The treatment with inhibitors of angiotensin-converting enzyme (ACE) was conducted in 57 patients with chronic diffuse renal diseases. Of them 45 patients received Capoten, 12 patients Renitek. ACE inhibitors were examined for effects on arterial pressure, proteinuria, renal and intrarenal hemodynamics. A hypotensive effect was apparent in hypertension and minimal in normotension. One month later renal bloodflow increased, glomerular filtration rate did not change. ACE inhibitors proved able to correct intrarenal hypertension: renal functional reserve returned to normal on posttreatment month 1-3 in 10 of 16 patients. Noticeable antiproteinuria effect of the drugs emerged 3 months after the treatment.
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PMID:[The use of angiotensin-converting enzyme inhibitors in chronic diffuse kidney diseases]. 763 69

Sixty-eight cases of non-insulin dependent diabetes mellitus (NIDDM) complicated with nephropathy were randomly divided into two groups: treated group, 35 cases treated with alcohol extraction of Abelmoschus manihot, Gliclazide and Captopril tablets; control group, 33 cases treated with Gliclazide and Captopril tablets, over a period of 8 weeks. The total effective rate in treated and control group were 83.87% and 31.03%(P < 0.01), urinary micro-albumin were 31.7 mg/L and 76.3 mg/L (P < 0.05), proteinuria were 0.41 g/24h and 0.77 g/24h (P < 0.01), blood beta 2-microglobulin were 3317.8 ng/ml and 3473.1 ng/ml (P < 0.05), urinary beta 2-microglobulin were 367.2 ng/ml and 641.5 ng/ml (P < 0.01), urinary N-acetyl-beta-glucosaminidase (NAG) were 26.3 u/L and 66.7 u/L (P < 0.01), plasma lipid peroxide (LPO) were 6.13 nmol/L and 8.78 nmol/L (P < 0.05), and plasma superoxide anion were 8.36 kcpm and 10.42 kcpm respectively (P < 0.05). It was suggested that Abemoschus manihot alcohol extraction could eliminate oxygen free radicals, alleviate renal tubular-interstitial diseases, improve renal function and reduce proteinuria.
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PMID:[Clinical observation on diabetic nephropathy treated with alcohol of Abelmoschus manihot]. 764 Apr 95

The present study assessed the extent to which remission of nephrotic-range proteinuria occurred in patients with Type I diabetes enrolled in the Captopril Study, a placebo controlled multicenter clinical trial of captopril therapy in diabetic nephropathy. Of the 409 patients recruited into the Captopril Study, 108 had nephrotic-range proteinuria (> 3.5 g/24 hr) at entry in the Study (baseline). This group was the subject of the present study. Remission of nephrotic-range proteinuria was defined as follows: (1) Onset of the remission was taken as the date when proteinuria was first noted to be < or = 1.0 g/24 hr. (2) The reduction in proteinuria had to be sustained for a minimum of six months and until the end of the Captopril Study. (3) During the remission, the average of all 24 hour proteinuria measurements could not exceed 1.5 g. (4) Decline in renal function could not explain the reduced proteinuria. That is, the patient's serum creatinine during the entire period of observation in the Captopril Study had to remain at less than a doubling of the baseline serum creatinine. Remission of nephrotic-range proteinuria occurred in 7 of 42 patients assigned to captopril (16.7%, mean follow-up 3.4 +/- 0.8 years) and in 1 of 66 patients assigned to placebo (1.5%, mean follow-up 2.3 +/- 1.1 years; P = 0.005, comparing remission rate in captopril vs. placebo-treated patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Remission of nephrotic range proteinuria in type I diabetes. Collaborative Study Group. 770 28

We studied the efficacy of captopril, an angiotensin-converting enzyme inhibitor in treating persistent moderate or severe proteinuria in children with various glomerular diseases other than minimal-change nephrotic syndrome. Captopril was administered for 3 months to 15 normotensive and nonazotemic or mildly azotemic patients (12 boys, 3 girls) in whom corticosteroid and cytotoxic treatment had failed to induce remission. Urinary protein excretion decreased from 2873.14 +/- 1937.50 (mean +/- s.e.m.) to 1684.71 +/- 1463.13 mg/day (P < 0.05). The reduction in proteinuria was not related to a significant fall in systemic blood pressure or a change in renal function. Serum albumin did not rise and side effects due to captopril were not observed. We concluded that, in the short term, captopril can be used safely and effectively for decreasing the proteinuria of nephrotic children unresponsive to conventional therapy.
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PMID:Efficacy of captopril treatment in children with steroid-resistant nephrotic syndrome. 787 77

Antiproteinuria effects of angiotensin-converting enzyme (ACE) inhibitors was studied in 23 patients with chronic nephritis (CN) and 32 patients with diabetic nephropathy (DN). CN patients received Capoten, DN patients were given enalapril. The drugs were also examined for the action on systemic arterial pressure, renal function and intrarenal hemodynamics. Significantly decreased urinary excretion of protein occurred in DN patients on the treatment month 1, in CN subjects on month 3. In both groups ACE inhibitors produced marked hypotensive effect, did not affect renal function, noticeably improved intraglomerular hemodynamics. Hypotensive and antiproteinuria activity of the drugs were unrelated. The mechanism of antiproteinuria action of ACE inhibitors works via normalization of intrarenal hemodynamics. Systemic arterial hypertension seems to be an additional factor aggravating disturbances of intrarenal circulation and provoking proteinuria.
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PMID:[The antiproteinuric action of angiotensin-converting enzyme inhibitors in chronic glomerulonephritis and diabetic nephropathy]. 794 Mar 57


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