You have accessJournal of UrologyStone Disease: Basic Research1 Apr 20101974 ROLE OF TOTAL ANGIOTENSIN BLOCKADE ON RECOVERABILITY OF RENAL FUNCTION AFTER RELIEF OF CHRONIC PARTIAL UNILATERAL URETERAL OBSTRUCTION Shady Soliman, Ahmed Shokeir, Ahmed Mosbah, Hassan Abol-Enein, Nashwa Barakat, Essam Abou-Bieh, and Ehab Wafa Shady SolimanShady Soliman More articles by this author , Ahmed ShokeirAhmed Shokeir More articles by this author , Ahmed MosbahAhmed Mosbah More articles by this author , Hassan Abol-EneinHassan Abol-Enein More articles by this author , Nashwa BarakatNashwa Barakat More articles by this author , Essam Abou-BiehEssam Abou-Bieh More articles by this author , and Ehab WafaEhab Wafa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1984AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate of the effect of total angiotensin blockade (ACEI (enalapril) + angiotensin receptor blocker losartan) on prevention of deterioration of renal function during partial unilateral ureteral obstruction (PUO) and to study their impact on enhancement of recoverability of renal function after relief of obstruction. METHODS Fifty six male mongrel dogs were classified into 5 groups: sham (8; sham surgery + no medications), control (12; left PUO + no medications), and 3 study groups; 12 dogs each; left PUO + either enalapril; losartan or combination. The study and control groups were subjected to 4 weeks PUO. After that, dogs of the control and study groups were reopened and subjected to Lich-Grigoir ureterovesical re-implantation. Dogs of the control and the study groups were sacrificed by the 8th week after relief of obstruction after being evaluated at basal condition, by the end of the 4th week of obstruction and at 4 and 8 weeks after relief of obstruction by measurement of selective endogenous creatinine clearance, selective renographic clearance and renal resistive index (RI). Dogs of the sham group underwent sham surgery at basal, 4 and 8 weeks and were subjected to same evaluation. RESULTS Sham surgery showed no significant impact on any of the evaluated parameters. Compared with the control, combination therapy saved reduction of creatinine clearance by 13% of the basal value and saved reduction of the renographic clearance by 20 % of the basal value by the end of the 4th week of obstruction. During PUO, combination therapy adds no significant benefit compared with the use of either drug alone. The renoprotective effect after 4- week obstruction was 18 % for the losartan, 12% for the enalapril and 20 %for the combination. Moreover, compared with the control, combination therapy enhanced regain of creatinine clearance by 18 % of the basal value and enhanced regain of renographic clearance by 34 %. Combined therapy significantly enhanced recoverability of renal function compared with either drug alone. Compared with the controls, enhancement of the recoverability of renal function after 8 -week relief of 4- week obstruction was 24 % for the losartan, 23% for the enalapril and 34 %for the combination (P<0.001). In addition, the increase of RI was significantly less in the three study groups. CONCLUSIONS Total angiotensin blockade decreases deterioration of renal function in partial UUO and enhances recoverability of renal function after relief of obstruction. The effect was more pronounced during recoverability phase. Mansoura, Egypt© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e766 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shady Soliman More articles by this author Ahmed Shokeir More articles by this author Ahmed Mosbah More articles by this author Hassan Abol-Enein More articles by this author Nashwa Barakat More articles by this author Essam Abou-Bieh More articles by this author Ehab Wafa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...