Key result
Cilazapril improves creatinine clearance and cuts protein excretion ~38% in hypertensive diabetics with renal insufficiency.
Why the study?
The efficacy and safety of cilazapril in hypertensive type II diabetics with chronic renal insufficiency were not established.
Does cilazapril improve blood pressure and renal function in hypertensive type II diabetics with chronic renal failure?
Does cilazapril improve blood pressure and renal function in hypertensive type II diabetics with chronic renal failure?
Cilazapril effectively lowers blood pressure and improves renal function parameters in high-risk hypertensive type II diabetics with chronic renal failure.
Answers are grounded in this paper and cite their sources.
May support short-term renal benefits of cilazapril in hypertensive diabetics with insufficiency; hypothesis-generating and requires RCT confirmation.
The purpose of this study was to determine efficacy and safety of the angiotensin converting enzyme inhibitor, cilazapril, in the treatment of hypertensive diabetics with renal insufficiency. Fifteen type II diabetics with hypertension and chronic renal insufficiency aged (mean +/- SD) 64 +/- 7 years were studied in a regional clinic and university hospital hypertension unit. The blood pressure was measured biweekly. Urinary collections were done after 2 weeks of placebo and 8 weeks of cilazapril treatment. The blood pressure decreased from 176 +/- 15/105 +/- 9 to 164 +/- 11/95 +/- 9 mm Hg and serum creatinine from 197 +/- 69 to 179 +/- 73 mumol/L. The creatinine clearance rose from 41.6 +/- 11.4 to 47.4 +/- 14.9 ml/min, while protein excretion decreased from 0.8 +/- 1.3 to 0.5 +/- 0.8 g/24 h (p less than 0.05). The blood pressure change was inversely correlated with the creatinine clearance change (r = -0.5, n = 15, p less than 0.05). In these high-risk patients, 8 weeks of cilazapril treatment improved both blood pressure control and renal function but renal function improved most in the patients whose blood pressure changed the least.
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Bursztyn et al. (1991) studied Hypertensive type II diabetics with chronic renal failure (n=15). Cilazapril vs. Placebo (baseline) was evaluated on Creatinine clearance and protein excretion (p=<0.05). Cilazapril treatment for 8 weeks improved creatinine clearance (41.6 to 47.4 ml/min) and decreased protein excretion (0.8 to 0.5 g/24 h, p<0.05) in hypertensive diabetics with renal insufficiency.
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