Long-Term Effect of Imidapril Hydrochloride Compared With Dilazep Hydrochloride Administration on Blood Pressure and Renal Function in Patients With Chronic Glomerulonephritis

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The objective of the present study was to compare the effects of imidapril hydrochloride, an angiotensin converting enzyme inhibitor, and dilazep hydrochloride, an antiplatelet agent, on urinary protein excretion and renal function in patients with chronic glomerulonephritis.
Imidapril (2.5 or 5 mg/day) or dilazep (300 or 450 mg/day) was administered for 3 years. Blood pressure, proteinuria, and renal function were measured before and during the treatment. In the group administered imidapril (n = 11), urinary protein decreased by approximately 50% (2.16 ± 1.57 versus 0.90 ± 0.53 g/g Cr, P < 0.01) and blood pressure by 14/10 mmHg (139.6 ± 17.4/93.6 ± 8.7 mmHg versus 122.7 ± 10.5/81.8 ± 9.9 mmHg, P < 0.01) and both remained at low levels during the three years of treatment. No correlation was observed between the extent of blood pressure reduction and changes in urinary protein. Serum creatinine concentrations did not change significantly (1.3 ± 0.3 versus 1.3 ± 0.3 mg/dL, NS). In the dilazep group (n = 12), there were no significant changes in blood pressure, urinary protein, or serum creatinine.
These findings demonstrate that imidapril reduces proteinuria and contributes to preserve renal function, suggesting its usefulness in the treatment of patients with chronic glomerulonephritis.