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ORTA DERECEDE KRONİK BÖBREK YETERSİZLİĞİ OLAN HASTALARDA ANJİOTENSİN DÖNÜŞTÜRÜCÜ ENZİM İNHİBİTÖRLERİ İLE ANGİOTENSİN RESEPTÖR ANTAGONİSTLERİNİN KARŞILAŞTIRILMASI

THE COMPARISON OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS AND ANGIOTENSIN RECEPTOR ANTAGONISTS IN PATIENTS WITH MODERATE CHRONIC RENAL FAILURE

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Abstract (2. Language): 
In this prospective-randomised study, the effects of angiotensin converting enzyme inhibitors (enaiapril) and angiotensin receptor antagonists (losartan) use on various laboratory parameters in 27 patients with moderate chronic renal failure were compared regarding safety and efficacy of both. The follow-up time was 6 month. Thirteen patients (M/F:3/10, mean age:41 ± 15 years) for enaiapril and 14 patients (M/F:4/10, mean age:5J±13 years) for losartan were included. There was no difference for age, gender and primary renal disease between two groups. More significant decrease in systolic blood pressure was observed in enaiapril group (from 142±21 mmHg to 133±23 mmHg, p<0.001) than losartan group (from 153±13 mmHg to 139±13 mmHg, p<0.05). No significant change after treatment was found between study groups. Serum K levels were significantly increased after treatment in enaiapril group (from 4,7±0,6 to 5,4±0,5 mmHg, p<0.05), but no significant change in losartan group was observed. Serum uric-acid levels were significantly decreased (from 6.2 ± 1,8 to 5.8 ± 1.6, p=0.01) in losartan group, but no change in enaiapril group was found. In conclusion, better blood pressure control could be obtained with enaiapril compared to losartan in this group of patients. Deterioration in renal function in both groups were similar. However, serum potassium levels elevated more in the enaiapril group than losartan. Decrease in serum uric acid levels after losartan may be a superiority compare to enaiapril treatment.
Abstract (Original Language): 
Buprospektif-randomize çalışmada, orta derecede kronik böbrek yetersizliği olan 27 hastada anjiotensin dönüştürücü enzim inhibitörleri (enaiapril) ve anjiotensin reseptör antagonistlerinin (losartan) çeşitli laboratuar parametreleri üzerine olan etkileri açısından güvenilirlik ve etkinliği karşılaştınlmıştır. İzleme süresi 6 aydı. Enaiapril kullanan 13 (E/K: 3/10, ortalama yaş: 4!±J5) ve losartan kullanan 14 (E/K: 4/10, ortalama yaş: 51±13) hasta çalışmaya alındı. İki grup arasında yaş, cinsiyet ve primer renal hastalık açısından bir fark yoktu. Enaiapril grubunda (142+21 mmHg'dan 133+23 mmtig'ya, p<0.001) sistolik kan basıncında losartan grubuna (15 3 ±13 mmHgdan 139 ±13 mmHg'ya, p<0.05) göre daha anlamlı düşme saptandı. Enaiapril grubunda serum potasyum düzeyleri tedavi sonrası anlamlı olarak artarken (4.7±0.6 inEq/L'den 5.4±0.5 mEg/L'ye, p<0.05), losartan grubunda anlamlı bir değişiklik gözlenmedi. Serum ürik asit düzeyleri de losartan grubunda anlamlı olarak azalırken (6.2±1.8 mg/dlden, 5.8±1.6 mg/dl'ye, p=0.01), enaiapril grubunda değişiklik görülmedi. Sonuç olarak, losartanla karşdaştırıldığında enaiapril ile daha iyi kan basıncı kontrolü elde edilebilir. Renal fonksiyondaki bozulma her iki grupta da benzerdi. Ancak, serum potasyum düzeyleri enaiapril grubunda losartan grubuna göre daha fazla yükselmiştir. Losartan tedavisi sonrası serum ürik asit düzeylerindeki azalma enaiapril tedavisine göre bir üstünlük olarak kabul edilebilir.
FULL TEXT (PDF): 
153-157

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