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IMMUNOSUPRESSIF TEDAVİYE DİRENÇLİ NEFROTIK SENDROMLU HASTALARDA LOSARTAN VE ENALAPRİL TEDAVİLERİNİN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI

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Abstract (2. Language): 
Comparalive effccts of losartan and enalapril on proteinuria in palient with ncphrotic syndro-me resistant (o immunosuppressive therapy. In this study we aimed to compare thc efficacy of losartan and enalapril in symptonıatic treatmenl of proteinuria. 23 patients who had nephrotic range proteinuria vvere evaluated. Patients in losartan group wcre compared with hîstoric cont¬rols who had receİved enalapril and foIIowed up at our oul-patients clinic. Eleven patients (5 male, 6 female, mean age: 35.1±18.4 ycars) tor losartan group were ineluded. The amount of proteinuria significantly decreased from 8.33+3.81 g/day to 3.92+2.73 g/day İn losartan group (p-0.006). As for enalapril group, the amount of proteinuria was decreased from 6.52+.4.13 gr/day to 3.8±2.9 g/day at 3[d months (p<0,05). However, it returned to baseline levels (6.10+4.24 gr/day) at 6'th. month. This finding was attrıbuled to thc noncompliance of Üıe his-torical control group of the patients for dİctary protein and/or salt intakc. Mean arteriaî biood pressure decreased in the first month of the treatment in both study groups. No significant change in the BUN, serum ercatinine, Na, K, albumin and uric acid levels was deteeted. Thc mean hemoglobin levels were decreased in losartan group after 5 month of the therapy (p=0.034). In conelusion, losartan decreases thc amount of proteinuria in patients wİth immunosuppressive therapy-resistant nephrotic syndrome and provides morc antiproteinuric cffect as compared to enalapril.
Abstract (Original Language): 
Bu çalışmada, proteinürinin semptomalik tedavisinde losartan ile enalaprilin etkinliğini karşılaştırmak amaçlanmıştır. Çalışmada nefrotik düzeyde proteinürisİ olan ve immunosuppressif tedaviye dirençli 23 hasta değerlendirilmiştir. Çalışmamızda losartan grubundaki hastalar, daha önce poliklinik takibinde enalapril tedavisi altında olan historik kontrol grubu ile karşılaştj-nlmıştır. Bu amaçla çalışmaya losartan grubunda 11 (5 erkek, 6 kadın, ortalama yaş 35.1+18.4 yıl) ve enalapril grubunda 12 (6 erkek, 6 kadın, ortalama yaş 35.8+11.9 yıİ) hasta incelenmiştir. Losartan grubunda tedavi sonrasında proteinim miktarında 8.33+3.81 g/gün'den 3.92+2.73 g/gün'e anlamlı bir düşme görülmüştür (p=0,666). Enalapril grubunda İse proteinüri miktarı 6.52+4.13 g/gün'c tekrar yükselmiştir. Bu durum muhtemelen enalapril grubunun historik kontrol olması ve hastaların diyetle alman protein ve tuz ahmına iyi uyum göstermemesi nedeni iledir. Ortalama kan basınçlarında her İki çalışma grubunda tedavinin 1. ayında anlamlı düşme saptanmıştır. Serum BUN, krealinin, Na, K, albumin ve ürik asit düzeyleri açısından her iki grupta anlamlı değişiklik saptanmamıştır. Losartan grubunda hemoglobin düzeyi 5. ayda anlamlı olarak düşmüştür (p-0.034). Sonuç olarak immunosupressif tedaviye dirençli nefrotik sendromda losartan proteinüri miktarını enalaprile göre daha etkin ve anlamlı bir şekilde olarak düşürmektedir
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REFERENCES

References: 

1. Apperloo AJ, de Zecuw D, dc Jong PE: SlıorHerm anlip-roteinuric response to anlİhypcrtcnsivc Irealment prediets loııg-term GR dceline in patients wİ!h non-dtabclic renal disease. Kidney Int 45:174 (1994).
2. Bİanchİnİ G, Letizia C, Domenici A, Scavo D: The cffect lo enalapril on nephrotic proteinuria and detennination of seram angiotensin-conversing enzyme before and after trcatmem. Drugs Exp Clin Res 17:263 (1991).
3. De Zeeuw DD, Gansevoort RT, Dullaarl PF, Dc Jong PE: Angiotensin II antagonism improves the lipoprolein profile in patients wilh nephrotic syndrome. Joumal of Hypertension 13:53 (1995).
4. Ecder ST: Angiotensin II anlagonistlcrinin rcnoprotcklif etkisi. AH Konseyi Bülteni 1:3ü (1998).
5. Gansevoort RT, de Zccuw D, de Jong PE: Long-tcrm be-nefits of thc antiproteinuric effcct of ACE inhibition in non-diabetic renal disease. Am J Kidney Dis 2:202 (1993)
6. Gansevoort RT, Heeg JE, Vriesendoıp R, De Zeeuw D, üe Jong PE: Anliproleinuric drugs in patients with idio-palhic membranous glomerulopalhy. Nephrol Dial Transp7:91 (1992).
7. Gansevoort RT, De Zeeuw D, Shahinfar S, Redfield A, De Jong PE: Effects of the angiotensin II antagonis! losartan in hypertensive patients with renal disease. Journal of Hypertension 12:37 (1994).
8. Hutchison FN, Webster SK: Effect of ANG II receptor
İmmunosupressif Tedaviye Dirençli Nefrotik Sendromlu Hastalarda Losartan ve Enalapril Tedavilerinin Etkinliklerinin Karşılaştırılması
antagonist on albuminuria and renal funcîion in passivc Hcymann nephritis. Anı J Physiyol 263:311 (1992).
9. Jacobson HR: Chronic renal failure: PathophysioSogy. Lancel 338:419(1991).
10. Kamper AL, Strangaard S, Leyssac PP: ElTect of enalapril on the progression of chronic renal failure. Anı J Hypertension 5:423 (1992).
11. Klahr S: Chronic renal failure: management. Lancet 338:423 (1991)
12. Maschio G, Alberti D, Janitı, Locatelli F, Mann JFE, Motolese M, Ponticclli C, Ritz E, Zucehclli P: Effect of the Angioteıısin-Converting-Enzyme İnhibitor Bcnazep-
ril on the Progression of Chronic Renal Insufficİency. N Engl JMed 334:939(1996).
13. Peterson JC, Adler S, Burkant JM, et al: Blood pressure conıroİ, proteinuria and the progressive of renal disease. The modifiealion on diet in renal disease study. Ann In-tern Med } 0:754 (1995).
14. Praga M, Hernandez E, Montoyo C, Andres A, Ruilope LM, Rodicio JL: Long-lerm beneficial cffects of angio-tensin-converting enzymc inhibition in patients witiı nephrotic proteinuria. Am j Kidney Dis 20:240 (1992).
15. Zoccali C, Valvo E, Ruso D, Panichi V, Zuccala A: An-tiproleinuric effect of losartan in patients with chronic renal discases. Nephrol Diat Transplant 12:234 (1997).

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