Muhammad Sharif, Rauf Niazi.
Role of Lisinopril (ACE inhibitor) in hypertensives with renal impairment.
J Pak Inst Med Sci Jan ;13(2):670-4.

This was a 12 week prospective study conducted to evaluate the efficacy and safety of lisinopril (ACE inhibitors) in hypertensive patients with chornic renal insufficiency. Thirty patients (mean age 52.2 yrs), having sitting diastolic blood pressure >95 and < 120 mm Hg with creatinine clearance (CLcr) between 10-60 ml per min per 1.73 m2 were recruited frons general population. Renal insufficiency was considered as mild if CLcr was between 30-60 ml/min and severe if between 10-29 ml/min. Initial 2 week placebo washout period wasfollowed by 12-week treatment with Lisinopril. After 12 weeks administration of Lisinopril, mean reduction in diastolic blood pressure was significant (p < 0.01). The over all mean reduction ranged from 5 nun Hg after treatment of one week duration to 20 mm Hg at week 12. The drug did not show any improvement in proteinuria. The change in creatinine clearance was non-significant. However, the serum potassium rose highly significantly front 4.5 to 5.4 mEq/L (p < 0.001). It is concluded that Lisinopril is effective in reducing the blood pressure in patients having renal insufficiency. Moreover it was well tolerated and in none of the patient there was any deterioration in renal function detected. However, the possibility of severe hyperkalemia calls for careful monitoring of serum potassium.

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