Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

High serum enalaprilat in chronic renal failure

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Increased risk of Staphylococcus aureus bacteremia in hemodialysis-A nationwide study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Important Aspects of Pharmacist-led Medication Reviews in an Acute Medical Ward

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND: Most angiotensin-converting enzyme (ACE) inhibitors and their metabolites are excreted renally and doses should hence be reduced in renal insufficiency. We studied whether the dosage of enalapril in daily clinical practice is associated with drug accumulation of enalaprilat in chronic renal failure.

METHODS: Fifty nine out-patients with plasma creatinine >150 micromol/L and chronic antihypertensive treatment with enalapril were investigated, in a cross-sectional design.

RESULTS: Median glomerular filtration rate (GFR) was 23(range 6-60) ml/minute/1.73 m2. The daily dose of enalapril was 10 (2.5-20) mg and the trough serum concentration of enalaprilat was 31.8 (<2.5-584.7)ng/ml. Ninety percent of the patients had higher serum concentrations of enalaprilat than has been reported in subjects with normal kidney function, and a marked elevation of serum enalaprilat was observed in patients with GFR <30 ml/minute. All but three patients had serum ACE activity below the reference range. The ACE genotype did not influence the results. Additional pharmacokinetic studies were done in nine patients in whom GFR was 23 (10-42)ml/minute/1.73 m2. The median clearance of enalaprilat was 28 (16-68) ml/minute and correlated linearly with GFR (r=0.86, p=0.003). Intra-subject day-to-day variation in trough concentrations was 19.7%.

CONCLUSION: Patients with chronic renal failure given small or moderately high doses of enalapril may thus have markedly elevated levels of serum enalaprilat. Whether this affords extra renoprotection, or on the contrary may inappropriately impair renal function, is not known, and should be investigated in prospective, controlled studies.

OriginalsprogEngelsk
TidsskriftJournal of the renin-angiotensin-aldosterone system : JRAAS
Vol/bind2
Udgave nummer4
Sider (fra-til)240-5
Antal sider6
ISSN1470-3203
DOI
StatusUdgivet - dec. 2001

ID: 44947551