Abstract
The renal function (BUN and Cr) was retrospectively evaluated before and during administration of captopril (angiotensin I converting enzyme inhibitor) in patients with essential hypertension (n=8), renal hypertension (n=5), hypertension with chronic renal failure due to renal tuberculosis (n=1, solitary kidney) and renovascular hypertension (n=8, bilateral (n=6) and unilateral (n=2)), Captopril (daily dose 37.5150 mg) was given from 1.5 months to 48 months in these patients whose blood pressure was not controlled below 150/100 mmHg following administration of other antihypertensive drugs such as diuretics, vasodilators, calcium-antagonists and β-blockades. Renal function did not deteriorate following administration of captopril in patients with essential hypertension. On the other hand, renal function deteriorated in two out of five cases with renal hypertension, in the hypertensive patient with chronic renal failure due to renal tuberculosis, and in two (only bilateral) out of eight cases with renovascular hypertension. Especially, renal function deteriorated rapidly in one case with renal failure due to renal tuberculosis and in one case with bilateral renovascular hypertension, which improved rapidly after discontinuing administration of captopril. The patients with renal and bilateral renovascular hypertension in whom renal function deteriorated had high plasma renin activity and serum creatinine level of more than 1.5 mg/dl before administration of captopril. Serum potassium was elevated following administration of captopril in all of 5 cases with renal hypertension, and in the hypertensive patient with renal failure, and in three out of eight cases with renovascular hypertension. These findings suggest that captopril should be carefully administered in patients with renal and bilateral renovascular hypertension.
