Effects of Diltiazem or Lisinopril on Massive Proteinuria Associated with Diabetes Mellitus

Brief Reports1 May 1990Effects of Diltiazem or Lisinopril on Massive Proteinuria Associated with Diabetes MellitusGeorge L. Bakris, MDGeorge L. Bakris, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-9-707 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecent studies in hypertensive, diabetic rats have shown that angiotensin-converting enzyme inhibitors reduce urinary protein excretion and preserve renal function to a greater extent than other antihypertensive agents (1, 2). The effects of calcium channel antagonists on urinary protein excretion and renal hemodynamics vary (3, 4). The renal hemodynamic effects of diltiazem, however, have been shown to be similar to angiotensin-converting enzyme inhibitors (5, 6). We did a prospective crossover trial with diltiazem or lisinopril in eight diabetic, hypertensive patients with nephrotic-range proteinuria to compare the renal effects of these agents.Patients and MethodsEight noninsulin-dependent diabetic patients (three men...References1. AndersonRennkeGarciaBrenner SHDB. Short and long term effects of antihypertensive therapy in the diabetic rat. Kidney Int. 1989;36:526-36. CrossrefMedlineGoogle Scholar2. ZatzDunnMeyerAndersonRennkeBrenner RBTSHB. Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest. 1986;77:1925-30. CrossrefMedlineGoogle Scholar3. JacksonCubelaDebreviWhittyJohnston BRLMC. Disparate effects of angiotensin converting enzyme inhibitor and calcium blocker treatment on the preservation of renal structure and function following subtotal nephrectomy or streptozotocin-induced diabetes in the rat. J Cardiovasc Pharmacol. 1987;10(Suppl 10):5167-9. Google Scholar4. MimranInsuaRibsteinMonnierBringerMirouse AAJLJJ Contrasting effects of Captopril and nifedipine in normotensive patients with incipient diabetic nephropathy. J Hypertens. 1988;6: 919-23. CrossrefMedlineGoogle Scholar5. IsshikiAmodeoMesserliPegramFrohlich TCFBE. Diltiazem maintains renal vasodilation without hyperfiltration in hypertension: studies in essential hypertensive man and spontaneously hypertensive rat Cardiovascular Drugs and Therapy. 1987;1:359-66. CrossrefMedlineGoogle Scholar6. AndersonClareyRileyTroy SLSJ. Acute infusion of calcium channel blockers reduces glomerular capillary pressure in rats with reduced renal mass Abstract. Kidney Int. 1988;33:370A. Google Scholar7. SunderrajanReamsBauer SGJ. Long-term renal effects of diltiazem in essential hypertension. Am Heart J. 1987;114:383-8. CrossrefMedlineGoogle Scholar8. GiorgiGiorgide Almeida BurdmannSilvaMarcoudes DMEHM. Effects of lisinopril on the renal plasma flow and renin-angiotensin-aldosterone system in patients with essential hypertension. J Hypertens. 1986;4(Suppl 5):5420-2. Google Scholar9. EisenbachLiewBoylanManzMuir GJJNP. Effect of angiotensin on the filtration of protein in the rat kidney: a micropuncture study. Kidney Int. 1975;8:80-7. CrossrefMedlineGoogle Scholar10. Heegde Jongvan der Hemde Zeeuw JPGD. Efficacy and variability of the antiproteinemic effect of ACE inhibition by lisinopril. Kidney Int. 1989;36:272-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Ochsner Clinic, New Orleans, Louisiana. For current author address, see end of text. 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Melbourne Diabetic Nephropathy Study Group.Calcium-Channel Antagonists Reduce Renal Protein ExcretionRonald H. Lewis, MDThe Antiproteinuric Effect of Angiotensin-Converting-Enzyme Inhibitors in Human Renal DiseaseEffects of Different Calcium Antagonists on Proteinuria Associated with Diabetes MellitusBryan K. Demarie, MD, George L. Bakris, MD 1 May 1990Volume 112, Issue 9Page: 707-708KeywordsAngiotensin converting enzyme inhibitorCalcium channel blockerDiabetes mellitusEpidermal growth factorExcretionHemodynamicsNephrologyProteinsProteinuria Issue Published: 1 May 1990 PDF DownloadLoading ...