Improving proteinuria, endothelial functions and asymmetric dimethylarginine levels in chronic kidney disease: ramipril versus valsartan.

Abstract

BACKGROUND:

The aim of this study was to find out whether the beneficial effects of the renin-angiotensin-aldosterone system (RAS) blockage in chronic kidney disease (CKD) has any relation with the alteration of asymmetric dimethylarginine (ADMA) levels.

METHODS:

Sixty-six nondiabetic patients with CKD and proteinuria and 36 healthy subjects were enrolled. Patients were treated with either ramipril 5 mg daily or valsartan 160 mg daily for 3 months. Proteinuria, ADMA, symmetric dimethyl arginine (SDMA), flow-mediated dilatation (FMD) and HOMA index measurements were performed both before and after the treatment.

RESULTS:

ADMA, SDMA, hsCRP levels, HOMA index and proteinuria of patients were significantly higher (p < 0.001 for all) and FMD, L-arginine and L-arginine/ADMA ratio in CKD were significantly lower than controls. According to the multiple regression analysis, proteinuria levels were independently related to ADMA and SDMA levels.

CONCLUSION:

Both drugs were equally effective in reducing elevated ADMA levels and improving endothelial dysfunction in CKD patients.

• Authors: Mahmut Ilker Yilmaz, Mutlu Saglam, Alper Sonmez, Kayser Caglar, Erdinc Cakir, Yasemin Kurt, Tayfun Eyileten, Mustafa Tasar, Cengizhan Acikel, Yusuf Oguz, Abdulgaffar Vural, Mujdat Yenicesu
• Journal: Blood purification (Blood Purif) Vol. 25 Issue 4 Pg. 327-35 ( 2007) ISSN: 1421-9735 [Electronic] Switzerland
• PMID: 17709915 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2007 S. Karger AG, Basel.

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Angiotensin-Converting Enzyme Inhibitors
• Biomarkers
• Blood Glucose
• Lipids
• Tetrazoles
• symmetric dimethylarginine
• N,N-dimethylarginine
• Valsartan
• C-Reactive Protein
• Arginine
• Valine
• Ramipril

Topics

• Adult
• Angiotensin II Type 1 Receptor Blockers (pharmacology, therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (pharmacology, therapeutic use)
• Arginine (analogs & derivatives, blood)
• Biomarkers
• Blood Glucose (analysis)
• C-Reactive Protein (analysis)
• Female
• Glomerular Filtration Rate (drug effects)
• Hemorheology
• Humans
• Insulin Resistance
• Kidney Failure, Chronic (blood, complications, drug therapy)
• Lipids (blood)
• Male
• Middle Aged
• Proteinuria (blood, drug therapy, etiology)
• Ramipril (pharmacology, therapeutic use)
• Renin-Angiotensin System (drug effects)
• Tetrazoles (pharmacology, therapeutic use)
• Valine (analogs & derivatives, pharmacology, therapeutic use)
• Valsartan
• Vasodilation (drug effects)