Abstract
The clinical usefulness of an angiotensin-converting enzyme inhibitor on the posturally induced fall in creatinine clearance (ClCr) was studied in patients with biopsy-proved chronic glomerulonephritis (CGN). After a change from supine to upright position, ClCr fell significantly in all patients. This fall was significantly ameliorated by the pretreatment with captopril (fall in ClCr 28.8 +/- 14.3% for nontreated vs 16.5 +/- 11.5% for treated patients; n = 12; p less than 0.05). The ameliorating effect was more marked in patients with mesangial cell proliferation (MP) than those without it (fall in ClCr 7.2 +/- 6.3% for MP vs 17.1 +/- 12.3% for no MP; n = 6; p less than 0.05). The results suggest that captopril apparently had a renoprotective effect on the orthostatic acute fall in ClCr in patients with CGN, especially those with MP.
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