Improving Proteinuria, Endothelial Functions and Asymmetric Dimethylarginine Levels in Chronic Kidney Disease: Ramipril versus Valsartan

• Published in: Blood purification Vol. 25; no. 4; pp. 327 - 335
• Main Authors: Yilmaz, Mahmut Ilker, Saglam, Mutlu, Sonmez, Alper, Caglar, Kayser, Cakir, Erdinc, Kurt, Yasemin, Eyileten, Tayfun, Tasar, Mustafa, Acikel, Cengizhan, Oguz, Yusuf, Vural, Abdulgaffar, Yenicesu, Mujdat
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2007
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Angiotensin II Type 1 Receptor Blockers - pharmacology; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Arginine - analogs & derivatives; Arginine - blood; Biological and medical sciences; Biomarkers; Blood Glucose - analysis; C-Reactive Protein - analysis; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerular Filtration Rate - drug effects; Hemorheology; Humans; Insulin Resistance; Intensive care medicine; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - drug therapy; Kidneys; Lipids - blood; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Nephrology. Urinary tract diseases; Original Paper; Proteinuria - blood; Proteinuria - drug therapy; Proteinuria - etiology; Ramipril - pharmacology; Ramipril - therapeutic use; Renin-Angiotensin System - drug effects; Tetrazoles - pharmacology; Tetrazoles - therapeutic use; Tumors of the urinary system; Valine - analogs & derivatives; Valine - pharmacology; Valine - therapeutic use; Valsartan; Vasodilation - drug effects; Asymmetric dimethylarginine; Ramipril; Valsartan; Proteinuria; Kidney disease; Tetrazole derivatives; Urinary system disease; Enzyme; Peptide hormone; Enzyme inhibitor; AT1 angiotensin receptor; Peptidases; Octapeptide; Biphenyl derivatives; Peptidyl-dipeptidase A; Aminoacid; Hydrolases; Peptidyl-dipeptidases; Antihypertensive agent; Angiotensin antagonist; Angiotensin II; Asymmetric dimethylarginine, Proteinuria; ACE inhibitor; Comparative study
• ISSN: 0253-5068; 1421-9735; 1421-9735
• DOI: 10.1159/000107410

Background: The aim of this study was to find out whether the beneficial effects of the renin-angiotensin-aldosterone system (RAS) blockage in chronic kidney disease (CKD) has any relation with the alteration of asymmetric dimethylarginine (ADMA) levels. Methods: Sixty-six nondiabetic patients with CKD and proteinuria and 36 healthy subjects were enrolled. Patients were treated with either ramipril 5 mg daily or valsartan 160 mg daily for 3 months. Proteinuria, ADMA, symmetric dimethyl arginine (SDMA), flow-mediated dilatation (FMD) and HOMA index measurements were performed both before and after the treatment. Results: ADMA, SDMA, hsCRP levels, HOMA index and proteinuria of patients were significantly higher (p < 0.001 for all) and FMD, L-arginine and L-arginine/ADMA ratio in CKD were significantly lower than controls. According to the multiple regression analysis, proteinuria levels were independently related to ADMA and SDMA levels. Conclusion: Both drugs were equally effective in reducing elevated ADMA levels and improving endothelial dysfunction in CKD patients.