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Abstract (2. Language): 
Comparalive effccts of losartan and enalapril on proteinuria in palient with ncphrotic syndro-me resistant (o immunosuppressive therapy. In this study we aimed to compare thc efficacy of losartan and enalapril in symptonıatic treatmenl of proteinuria. 23 patients who had nephrotic range proteinuria vvere evaluated. Patients in losartan group wcre compared with hîstoric cont¬rols who had receİved enalapril and foIIowed up at our oul-patients clinic. Eleven patients (5 male, 6 female, mean age: 35.1±18.4 ycars) tor losartan group were ineluded. The amount of proteinuria significantly decreased from 8.33+3.81 g/day to 3.92+2.73 g/day İn losartan group (p-0.006). As for enalapril group, the amount of proteinuria was decreased from 6.52+.4.13 gr/day to 3.8±2.9 g/day at 3[d months (p<0,05). However, it returned to baseline levels (6.10+4.24 gr/day) at 6'th. month. This finding was attrıbuled to thc noncompliance of Üıe his-torical control group of the patients for dİctary protein and/or salt intakc. Mean arteriaî biood pressure decreased in the first month of the treatment in both study groups. No significant change in the BUN, serum ercatinine, Na, K, albumin and uric acid levels was deteeted. Thc mean hemoglobin levels were decreased in losartan group after 5 month of the therapy (p=0.034). In conelusion, losartan decreases thc amount of proteinuria in patients wİth immunosuppressive therapy-resistant nephrotic syndrome and provides morc antiproteinuric cffect as compared to enalapril.
Abstract (Original Language): 
Bu çalışmada, proteinürinin semptomalik tedavisinde losartan ile enalaprilin etkinliğini karşılaştırmak amaçlanmıştır. Çalışmada nefrotik düzeyde proteinürisİ olan ve immunosuppressif tedaviye dirençli 23 hasta değerlendirilmiştir. Çalışmamızda losartan grubundaki hastalar, daha önce poliklinik takibinde enalapril tedavisi altında olan historik kontrol grubu ile karşılaştj-nlmıştır. Bu amaçla çalışmaya losartan grubunda 11 (5 erkek, 6 kadın, ortalama yaş 35.1+18.4 yıl) ve enalapril grubunda 12 (6 erkek, 6 kadın, ortalama yaş 35.8+11.9 yıİ) hasta incelenmiştir. Losartan grubunda tedavi sonrasında proteinim miktarında 8.33+3.81 g/gün'den 3.92+2.73 g/gün'e anlamlı bir düşme görülmüştür (p=0,666). Enalapril grubunda İse proteinüri miktarı 6.52+4.13 g/gün'c tekrar yükselmiştir. Bu durum muhtemelen enalapril grubunun historik kontrol olması ve hastaların diyetle alman protein ve tuz ahmına iyi uyum göstermemesi nedeni iledir. Ortalama kan basınçlarında her İki çalışma grubunda tedavinin 1. ayında anlamlı düşme saptanmıştır. Serum BUN, krealinin, Na, K, albumin ve ürik asit düzeyleri açısından her iki grupta anlamlı değişiklik saptanmamıştır. Losartan grubunda hemoglobin düzeyi 5. ayda anlamlı olarak düşmüştür (p-0.034). Sonuç olarak immunosupressif tedaviye dirençli nefrotik sendromda losartan proteinüri miktarını enalaprile göre daha etkin ve anlamlı bir şekilde olarak düşürmektedir



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