Captopril-Induced Renal Insufficiency and the Role of Sodium Balance

Excerpt

Acute reversible renal failure may complicate therapy with Captopril in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney (1-6). The concomitant use of diuretic agents in many of the reported cases of captopril-induced renal insufficiency has led to speculation that diuretic therapy or sodium depletion may contribute to the decrement in glomerular filtration rate mediated by angiotensin-converting enzyme inhibitors in the presence of a fixed reduction in renal perfusion pressure (1, 6). To determine the influence of sodium balance on captopril-induced renal insufficiency, the renal hemodynamic effects of Captopril were studied prospectively in a patient with