The application of angiotensin converting enzyme inhibitor administration in renal transplant recipients / 中国医师杂志

ABSTRACT

Objective To observe the protective role of enalapril as a specific angiotensin converting enzyme inhibitor on allograft in renal transplant recipients.Methods From Jan 2000 to Jun 2001,22 cases of renal transplant recipients with normal renal function and urine TGF-?_1 concentration being higher than 250.0 pg/mg Cr(group A) underwent therapy with angiotensin converting enzyme inhibitor(enalapril) one year after surgery.Enalapril was administered at a dose of 50 mg/d for the patients in group A for at least one year.Twenty-three recipients who never received angiotensin converting enzyme inhibitor in the same condition were studied as Group B.The adverse reactions of enalapril were investigated in group A and the expression of TGF-?_1mRNA in renal grafts were compared between before and 1 year after enalapril therapy.At the end of 3-year study period,the renal function,the decrement of creatinine clearance rate(Ccr) and the concentration of TGF-?_1 in blood and urine were compared between the two groups respectively.Results The Ccr decreased faster in group B than in group A.During three years study period,the decrements of Ccr were(5.1?4.6) and(13.7?9.5)(ml/min) in group A and group B respectively,and there were 2 cases and 9 cases with chronic allograft nephropathy(CAN) respectively.The decrement of Ccr and the number of CAN cases were significant difference between group A and group B(all P