Aim: 

Angiotensin converting enzyme (ACE) inhibitors are largely used for hypertension and heart failure; they are also renoprotective, slowing the progression of renal diseases towards renal failure by reducing proteinuria. We evaluated their effect on the renal function.

Material and methods: 

The study included 30 patients with chronic glomerular diseases, with proteinuria, haematuria and hypertension. They were divided in 3 groups, each of them receiving either 10 mg of Enalapril, 2 mg of Trandolapril or 20 mg of Fosinopril for 30 days. We evaluated the glomerular filtration rate with Cockroft-Gault formula, the changes in serum creatinine, proteinuria, blood pressure in the beginning, at 15 and 30 days of therapy.

Results: 

GFR had a mean decrease of 17.4% (from 101.6 to 83.9 ml/min). The decrease was constant in Enalapril patients; in Fosinopril patients, GFR increased at 15 days, but decreased at 30 days; in Trandolapril patients, GFR decreased at 15 days and had a slight increase after one month. Serum creatinine increased, but the values were not statistically significant (p < 0.05). In Enalapril patients, it had a slow, constant elevation; with Fosipril, it decreases at 15 days and normalizes at 30 days; with Trandolapril, it rises at 15 days and is maintained after 30 days. Proteinuria decreased with 43% and the blood pressure decreased from 154.4/94 to 143.9/84.2 mmHg after one month of ACE inhibitors.

Conclusion: 

The glomerular filtration rate and serum creatinine remain in the physiological limits during the therapy with ACE inhibitors. The changes in their values are not statistically significant.