You are here

ANJÎOTENSÎN KONVERTÎNG ENZÎM ÎNHÎBÎTÖRLERÎ, ANJÎOTENSÎN II RESEPTÖR ANTAGONÎSTLERÎ VE RENAL KORUMA

ANGIOTENSIN CONVERTING ENZYME INHIBITORS, ANGIOTENSIN II RECEPTOR ANTAGONISTS AND RENOPROTECTION

Journal Name:

Publication Year:

Abstract (2. Language): 
Recent studies have suggested that proteinuria is - not only a marker for renal disease but it also predicts those patients at greatest risk for development of chronic and progressive renal insufficiency. This effect of proteinuria on progression of renal disease is independent of other risk factors such as level of renal function, blood pressure and dyslipidemia. Multiple pharmacological and dietary modifications are necessary to achieve the optimal slowing of the progression of renal disease. Due to its hemodynamic, metabolic and growth promoting effects, angiotensin II may play an important role in the progression of renal disease. Currently, ACE inhibitors and angiotensin II receptor antagonists are commonly used for this purpose. Therefore, it is reviewed the literature data in this area including our experiences.
Abstract (Original Language): 
Son çalışmalar proteinürinin sadece böbrek hastalıklarının bir belirteci olmadığını, ayni zamanda bıı hastalarda kronik ve ilerleyici böbrek yetmezliği gelişimi için büyük bir riskin habercisi olduğunu düşündürmektedir. Proteinürinin böbrek hastalığının ilerlemesi üzerine bu etkisi, böbrek fonksiyonunun düzeyi, kan basıncı ve dislipidemi gibi diğer risk faktörlerinden bağımsızdır. Multipl farmakolojik yaklaşım ve diyet modifikasyonları böbrek hastalığının ilerlemesini optimal yavaşlatmak hçin gereklidir. Hemodinamik, metabolik büyümeyi başlatıcı etkileri nedeniyle angiotensin II böbrek hastalığının ilerlemesinde önemli bir rol oynayabilir. Günümüzde ACE inhibitörleri ve anjiyotensin II reseptör antagonistleri bu amaçla yaygın olarak kullanılmaktadır. Bu nedenle kendi deneyimlerimizi de içeren bu alandaki literatür bilgisi gözden geçirildi.
FULL TEXT (PDF): 
145-152

REFERENCES

References: 

1. Glassock RJ. Proteinuria In: Massry SG. Glassock R (eds): Textbook of Nephrology. Williams and Wilkins, Baltimore, 1995, pp: 600-604.
2. Ruggenenti P, Remuzzi G. Angiotensin-converting enzyme inhibitor therapy for non-diabetic progressive renal disease. Curr Opin Nephrol Hypertens 1997; 6:
489-495.
3. McLaughlin K, Jardine AG. Angiotensin converting enzyme inhibitors and angiotensin receptor (ATI) antagonists: either or both for primary renal disease?.
Nephrol Dial Transplant 1999; 14: 25-28.
4. Ruiz-Ortega M, Lorenzo O, Ruperez M, Edigo J. ACE inhibitors and ATI receptor antagonists-beyond the haemodynamic effect. Nephrol Dial Transplant 2000;
15:561-565.
5. Wolf G, Neilson EG. Angiotensin II as a renal growth
factor. J Am Soc Nephrol 1993; 3: 1531-1540.
6. Edigo J. Vasoactive hormones and renal sclerosis
(Nephrology Forum). Kidney Int 1999; 49: 578-597.
7. Ruiz-Ortega M, Gomez-Garre D, Alcazar R et al. Involvement of angiotensin II and endothelin on matrix protein production and renal sclerosis. J Hypertens 1994; 12: S51-S58.
8. Ruiz- Ortega M, Edigo J. Angiotensin II modulates cell growth-related events and synthesis of matrix proteins in renal interstitial fibroblasts. Kidney Int 1997; 52: 1497-1510.
9. Ruize-Ortega M, Bustos C, Hemandez-Presa MA et la. Angiotensin II participates in mononuclear cell recruitment in the kidney through nuclear factor-kappa B activation and monocyte chemoattractant protein-1 gene expression. J Immunol 1998; 161: 430-439.
10. Ruggenenti P, Perna A, Mosconi L. et al, for the Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). A randomized placebo controlled trial of the angiotensin-converting-enzyme inhibitor ramipril on the decline of the glomerular filtration rate and end stage renal failure in proteinuric, non-diabetic chronic
renal disease. Lancet 1997; 349: 1857-1863. .
1 I. Ruggenenti P, Gaspari F, Ferna A, Remuzel G. Cross sectional longitudinal study of spot morning urine protein: creatinine ratio, 24 hour urine protein excretion
rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without
diabetes. BMJ 1998; 316: 504-509.
12. Maschio G, Alberti D, Janin G et al and the Angiotensin-converting-enzyme inhibition in progressive renal insufficiency study group. Effect of the angiotensin-converting-enzyme inhibition benazapril on the progression of chronic renal
insufficiency. N Engl J Med 1996; 334: 939-945.
13. Ihle BU, Whitworth J A, Shahinfar S, Cnoan A,
Kincaid-Smith PS, Becker GJ. Angiotensin converting enzyme inhibition in nondiabetic progressive renal insufficiency: a controlled double blind trial. Am J
Kidney Di's 1996; 27(suppl): 30-33.
14. Giatras 1, Lau J, Levey AS. Effect of ACE inhibitors on the progression of non-diabetic renal disease: a meta-
analysis (Abstract). J Am Soc Nephrol 1996; 7: 1318.
15. Laffel LMB, McGill JB, Cans DJ et al, on behalf of the
North American Microalbuminuria Study Group: The beneficial effect of angiotensin-converting-enzyme inhibition with Captopril on diabetic nephropathy in normotensive IDDM patients with microalbuminuria. Am J Med 1995; 99: 497-504.
16. Ravid M, Savin H, Jutrin 1, Bental T, Lang R, Lishner M: Long-term effect of ACE inhibition on development of nephropathy in diabetes mellitus type II. Kidney Int
1994; 45(Suppl 45): 5161 -5164.
17. Gansevoort RT, de Zeeuw D, de Jong PE. Dissociation between the course of the hemodynamic and antiproteinuric effects of angiotensin I converting
enzyme inhibition. Kidney Int 1993; 44: 579-584.
18. El Nahas AM. Renal scarring: The role of angiotensin II. Nephrol Dial Transplant 1995; 10 (Suppl 9): 28-32.
19. Wolf G. Molecular mechanism of angiotensin II in the kidney: emerging role in the progression of renal disease: beyond haemodynamics. Nephrol Dial
Transplant 1998; 13: 1 131-1142.
20. Wolf G, Ziyadeh FN, Thaiss F et al. Angiotensin II stimulates expression of the chemokinc RANTES in rat glomerular endothelial cells. Role of the angiotensin
type 2 receptor. J Clin Invest 1997; 100: 1047-1058.
21. Bauer JH, Reams GP. Renal protective effect of long term antihypertensive therapy with enalapril. Drugs
1988; 35(suppl 5): 62-71.
22. Perico N, Remuzzi G, Angiotensin II receptor antagonists and treatment of hypertension and renal disease. Curr Opin Nehprol Hypertens 1998; 7: 571-8.
23. Lafayette RA, Mayer G, Pard SK, Meyer TW.
Angiotensin II blockade limits glomeruler injury in rats with reduced renal mass. J Clin Invest 1992; 90: 766¬771.
24. Remuzzi A, Perico N, Amuchastegu CS et al. Short-and long-term effect of angiotensin II receptor blockade in rats with experimental diabetes. J Am Soc Nephrol 1993;4:40-49.
i
50
25. Zoja C, Donadelli R, Corna D et al. The renoprotective properties of angiotensin-converting enzyme inhibitors in a chronic model of membranous nepropathy are solely due to the inhibition of angiotensin II evidence based on comparative studies with a receptor antagonist. Am J Kidney Dis 1997; 28: 254-264.
26. Benediktsson H, Chea R, Davidoff A, Paul LC. Antihypertensive drug treatment in chronic renal allograft rejection in the rat. Transplantation 1992; 62: 1634-1642.
27. Gansevoort RT, de Zeeuw D. The antihypertensive and renal effects of angiotensin II receptor antagonists: remaining questions. Curr Opin Nephrol Hypertens 2000; 9(1): 57-61.
28. Gansevoort RT, de Zeeuw D, Shahinfar S, Redfield A, de Jong PE. Effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease. J
Hypertens 1994; 12 (SuppI 2): 537-542.
29. Usta M, Dilek K, Yavuz M et al. Anti-proteinuric effect of angiotensin II receptor antagonist losartan in cases with glomerular lesions. Clinical Nephrol 2001; 55(3): 260-262
30. Usta M, Dilek K, Ersoy A ve ark. Nefrotik Sendrom
şeklinde seyreden renal amiloidozisli olgularda losartanın porteinüri üzerine etkisi. XVI. Ulusal Nefroloji, Hipertansiyon, Diyaliz ve Transplantasyon Kongresi, 14-16 Kasım, 1999. İzmir, Özet Kitabı, s:
248.
31. Gansevoort RT, de Zeuuw D, de Jong PE. Is the antiproteinuric effect of ACE inhibition mediated by interference in the renin-angiotensin system? Kidney Int 1994;45:861-867.
32. Nielsen SJ, Dollerup J, Nielsen B, Jensen B, Mogensen CE. Losartan reduces albuminuria in patients with essential hypertension an enalapril controlled 3 months
study. Nephrol Dial Transplant 1997; 12 (Suppl 2): 19¬23.
33. Ersoy A, Dilek K, Yavuz M et al. Angiotensin II receptor antagonist losartan reduces microalbuminuria in renal transplant recipients (Abstract). Nephrol
Dialysis Transplant 1999; 14 (9): A283.
34. Calvino J, Lens XM, Romero R, Sanchez-Guisande D. Long-term anti-proteinuric effect of losartan in renal transplant recipients treated for hypertension. Nephrol
Dial Transplant 2000; 15: 82-86.
35.
Dile
k K, Yavuz M, Usta M et al. The comparison öf antiproteinuric effects of angiotensin converting enzyme inhibitor enalapril and angiotensin II receptor antagonist losartan in nephrotic syndrome cases (Abstract). Nephrol Dial Transplant 1999; 14 (9): A 88.
36. Schulz E, Bech JN, Pedersen EP, Miiller GA for the
study group. A randomized, double-blind, parallel study on the safety and antihypertensive efficacy of losartan compared to captopril in patients with mild to moderate hypertension and impaired renal function.
Nephrol Dial Transplant 1999; 14 (suppl 4): 27-28.
37. Lewis EJ, Hunsicker LG, Clarke WR ct al for The Colloborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Eng J Med 2001; 345(12): 851-860.
38. Brenner Bm, Cooper ME, de Zeeuw D et al for the RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Eng J Med 2001;
345(12): 861-869.
39. Andersen S, Tamow L, Rossing P, Hansen BY, Parving HH. Renoprotective effects of angiotensin II receptor blockade in type 1 diabetic patients with diabetic
nephropathy. Kidney Int 2000; 57: 601-606.
40. Timmermans PB, Duncia V, Carini D. Discovery of losartan the first angiotensin-II receptor antagonist. J Human Hypertens 1995; 9 (Suppl 5): 503-518"
41. Chen K, Zimmermann BO. Comparison of renal hemodynamic effect of ramiprilat to captopril, possible role of kinins. J Pharmacol Exp Ther 1994; 270: 491¬497.
42. Pitt B, Segal R, Martinez FA et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study,
ELITE). Lancet 1997; 349: 747-752.
43. Pitt B, Poole-Wilson P, Segal R et al. Effects of losartan
versus captopril on mortality in patients with symptomatic heart failure: Rationale, design and baseline characteristics of patients in the losartan heart
failure survival Study-ELITE II. J Cardiac Fail 1999; 5
(2): 146-154.
44. Hebert LA, Falkenhain ME, O'Dorisio TM. Combined ACE inhibitor (ACEİ) and angiotensin II receptor antagonist (Allra) therapy in type II diabetes with renal manifestations: effects of combined therapy on renal
function (Abstract). J Am Soc Nephrol 1996; 9: 1359.
45. Weir MR, Henrich WL. Theoretical basis and clinical evidence for differential effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor subtype 1 blockers. Curr Opin Nephrol
Hypertension 2000; 9: 403-41 1.
46. Menard J, Duncan J, Campbell DJ, Azizi M, Gonzales ME. Synergistic effects of ACE inhibition and Ang II antagonism on blood pressure, cardiac weight and renin in spontaneously hypertensive rats. Circulation 1997;
96: 3072-3078.
47. Goodfriend TL, Elliot ME, Catt LI. Angiotensin
receptors and their antagonists. N Engl J Med 1996; 334: 1649-1654.
48. Liu YH, Yang XP, Sharov VG et al. Effects of angiotensin-converting enzyme inhibitors and angiotensin II type I receptor antagonists in rats with heart failure. Role kinins and angiotensin II type 2
receptors. J Clin Invest 1997; 99: 1626-1635.
151
49. Kohzuki M, Yasujima M, Liu PF et al. Cardiovascular and renal protective effects of losartan in spontaneously hypertensive rats with diabetes mellitus. Clin Exp Pharm Physiol 1997; 22: 5366-5367.
50. Peters H, Noble NA, Border WA. Targeting TGF-beta over-expression in renal disease: maximing the antifibrotic action of angiotensin II blockade. Kidney Int 1998; 54: 1575-1583.
51. Hebert LA, Falkenhain ME, Nahman NS, Cosio FG, O'Dorisio TM. Combination ACE inhibitor and angiotensin II receptor antagonist therapy in diabetic
nephropathy. Am J Nephrol 1999; 19: 1-6.
52. Schmitt F, Natov S, Martinez F et al. Renal effects of angiotensin I receptor blockade and angiotensin convertase inhibition in man. Clin Sci i 996; 90: 203¬213.
53. Azizi M, Guyene TT, Chatellier G ct al. Additive effects of losartan and enalapril on blood pressure and plasma active renin. Hypertension 1997; 29: 634-640.
54. Russo D, Pisani A, Balletta MM et al. Additive
antiproteinuric effect of converting enzyme inhibitor and losartan in normotensive patients with IgA
nephropathy. Am J Kidney Dis 1999; 33: 851-856.
55. Wolf G, Ziyadeh EN. The role of angiotensin II in diabetic nephropathy: Emphasis on nonhcmodynamic mechanisms. Am J Kidney Dis 1997; 29: 153-163.
56. Gibbons GH, Pratt RE, Dzau VJ. Vascular smooth muscle cell hypertrophy vs hyperplasia: Autocrine transforming growth factor 1 expression determines growth responses to angiotensin II. J Clin Invest 1992; 90:456-461.
57. Ruilope LM, Aldigier JC, Ponticelli C et al on behalf of European Group for the Investigation of Valsartan in Chronic Renal Disease. Safety of the combination of valsartan and benazepril in patients with chronic renal disease. J Hypertension 2000; 13: 89-95.
58. Yoshida H, Mitorai T, Kawamura T et al. Role of the deletion polymorphism of the angiotensin converting enzyme gene in the progression and therapeutic responsiveness of IgA nephropathy. J Clin Invest 1995;
96:2162-2169.
59. Tiret L, Bonnardeaux A, Poirier O et al. Synergistic effects of angiotensin-converting enzyme and angiotensin-II type I receptor gene polymorphisms on risk of myocardial infarction. Lancet 1994; 344: 910¬913.
60. Ishidoya S, Morriscy J, McCracken R, Reyes A, Klarh S. Angiotensin II receptor antagonist ameliorates renal tubulointerstitial fibrosis caused by unilateral
obstruction. Kidney Int 1995; 47: 1285-1294.
61. Wolf G, Schneider A, Helmchen UM, Stahl RA. AT1-receptor antagonists abolish glomerular MCP-I expression in a model of mesangial proliferative glomerulonephritis. Exp NephroF 1998; 6: 112-120
62. Morrissey JJ, Klahr S. Differential effects of ACE and ATI receptor inhibition on chemoattractant and adhesion molecule syntesis. Am J Physiol 1998; 274:
F580-586.
63. Wolf G, Ziyadeh FN, Thaiss F et al. Angiotensin II stimulates expression of the chemokines RANTES in rat glomerular endothelial cells. Role of the angiotensin
type 2 receptor. J Clin Invest 1997; 100: 1047-1058.
64. Ardaillou R, Chansel D. Synthesis and effects of active fragments of angiotensin II. Kidney Int 1997; 52: 1458¬1468.
65. Terui J, Tamoto K, Sudo J. Proteinuric potentials of angiotensin-II, DES-ASP(l)-angiotensin-II, and DES-
ASP(l), DES-ARG(2)-angiotensin-II in rats. Biol Pharm Bull 1994; 17: 1516-1518.
66. Ruiz-Ortega M, Lorenzo O, Egido J. Angiotensin III up-regulates genes involved in kidney damage in mesengial cells and renal interstitial fibroblasts. Kidney
Int 1998; 54(Suppl.68): S41-S45.
152

Thank you for copying data from http://www.arastirmax.com