Innappropriate renin secretion unmasked by captopril (SQ 14 225) in hypertension of chronic renal failure
Brunner, H.R.; Waeber, B.; Wauters, J.P.; Turin, G.; McKinstry, D.; Gavras, H.
Lancet 2(8092 Pt 1): 704-707
1978
ISSN/ISBN: 0140-6736 PMID: 80634 Document Number: 127489
Captopril an orally active inhibitor of angiotensin-converting enzyme, was given to 7 hypertensive patients with chronic renal failure whose plasma-creatinine ranged from 1.5-7.4 mg/dl; whose plasma-renin activity was normal; whose hypertension was not controled by previous therapy consisting in 5 patients of 3 or more antihypertensive drugs; and whose blood pressures averaged 176/111 .+-. 11/3 mm Hg. Inhibition of converting enzyme by oral captopril, 200 mg twice daily, reduced blood pressure to 156/100 .+-. 9/5 mm Hg. Patients (5) needed additional treatment by frusemide 40-250 mg/day orally. With this combined regimen the blood pressure of all patients averaged 126/85 .+-. 4/3 mm Hg after 8 .+-. 2 wk of captopril. The drug was well tolerated. Inhibition of angiotensin-converting enzyme with or without Na depletion is an efficient treatment for hypertension associated with chronic renal failure. Although renin levels in patients with this condition may be normal, they are inappropriate in relation to the subtle degree of Na retention that occurs with this disorder.