Angiotensin converting enzyme inhibition improves glomerular size-selectivity in IgA nephropathy

摘要: Angiotensin converting enzyme inhibition improves glomerular size-selectivity in IgA nephropathy. Clearances of uncharged dextrans broad size distribution were used to evaluate the effects a 30 day course enalapril on barrier function 10 patients with nephropathy and proteinuria (from 1.4 5.6 g/day). Dextran clearance experiments repeated three times: before therapy, after days again withdrawal. GFR, but not RPF, was significantly reduced by (basal 38.3 ± 11.9, 30.2 12.6 ml/min/1.73 m 2 ) returned basal values Urinary protein excretion fractional albumin both 2.3 1.1 g/day 102 90 × -5 , 1.2 0.6 51 23 respectively) Transglomerular passage large (radii 54 62 A), lower (26 42 A) lowered enalapril. When withdrawn dextran-sieving profile comparable baseline levels. A theoretical analysis dextransieving profiles indicated that radius largest membrane pores. This effect independent from hemodynamic changes. We conclude angiotensin inhibitors (CEI) humans reduces urinary primary action intrinsic properties enhancing size-selective function. The hypofiltration associated therapy these patients, which eliminated its withdrawal, has be taken into account as possible undesired CEI long-term treatment.