Captopril to mitigate chronic renal failure after hematopoietic stem cell transplantation: a randomized controlled trial.

To test whether the angiotensin-converting enzyme inhibitor captopril was effective in mitigating chronic renal failure after hematopoietic stem cell transplantation (HSCT).
A total of 55 subjects undergoing total body irradiation (TBI)-HSCT were enrolled in this randomized controlled trial. Captopril or identical placebo was started at engraftment and continued as tolerated until 1 year after HSCT.
The baseline serum creatinine and calculated glomerular filtration rate (GFR) did not differ between groups. The 1-year serum creatinine level was lower and the GFR higher in the captopril compared with the placebo group (p = 0.07 for GFR). Patient survival was higher in the captopril compared with the placebo group, but this was also not statistically significant (p = 0.09). In study subjects who received the study drug for more than 2 months, the 1-year calculated GFRs were 92 mL/min and 80 mL/min, for the captopril and placebo groups, respectively (p = 0.1). There was no adverse effect on hematologic outcome.
There is a trend in favor of captopril in mitigation of chronic renal failure after radiation-based HSCT.
AuthorsEric P Cohen, Amy A Irving, William R Drobyski, John P Klein, Jakob Passweg, Julie-An M Talano, Mark B Juckett, John E Moulder
JournalInternational journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 70 Issue 5 Pg. 1546-51 (Apr 1 2008) ISSN: 0360-3016 [Print] United States
PMID18029109 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiotensin-Converting Enzyme Inhibitors
  • Captopril
  • Creatinine
  • Adolescent
  • Adult
  • Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
  • Captopril (therapeutic use)
  • Child
  • Creatinine (blood)
  • Glomerular Filtration Rate
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Kidney Failure, Chronic (drug therapy, etiology)
  • Prospective Studies
  • Statistics, Nonparametric
  • Whole-Body Irradiation (adverse effects)

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