The antiproteinuric efficacy of
angiotensin-converting-enzyme inhibitors (ACEI) has been extensively investigated in patients with several types of nephropathy, but there are few data on the use of ACEI in patients with primary glomerular disease without renal function impairment. We evaluate the effect of long-term
therapy with
captopril on arterial pressure and
proteinuria in 13 patients with primary glomerular disease, selected on the following criteria: persistent
proteinuria greater than 600 mg/day, serum
creatinine less than or equal to 1.5 mg/dl, no
dietary restriction or
antihypertensive or immunosuppressive therapy for at least 9 months prior to enrolment. Ten of 13 patients were normotensive. The treatment with
captopril induced an early and persistent decrease in
proteinuria (41%), and a significant increase in
serum albumin. We did not find a significant correlation between changes in MAP and changes in
protein loss or between variations in serum
creatinine and in
proteinuria. Our results demonstrate that
captopril is effective in reducing
proteinuria in patients with primary glomerular disease with normal renal function. Since the antiproteinuric effect is not associated to a concomitant decrease in arterial pressure, we presume that it might be due to a specific intrarenal action of
captopril.