EFFECT OF 1-YEAR TREATMENT WITH NITRENDIPINE VERSUS ENALAPRIL ON URINARY ALBUMIN AND ALPHA-1-MICROGLOBULIN EXCRETION IN MICROALBUMINURIC PATIENTS WITH TYPE-1 DIABETES-MELLITUS - A RANDOMIZED, SINGLE-BLIND COMPARATIVE-STUDY

In order to compare the long-term effects of nitrendipine (CAS39562-70 -4) and enalapril (CAS 75847-73-3) on variables of glomerular and tubu lar function in type 1 diabetes mellitus, a single-blind, randomised c omparative 1-year study was carried out in microalbuminuric patients ( 6 women, 14 men, age, 30-58 years, duration of diabetes, 3-41 years, H b(A1c), 5.5-10 %). 10 patients were treated with 20 mg/d nitrendipine, 10 patients were treated with 10 mg/d enalapril. On the average, urin ary albumin excretion was decreased by 38 +/- 4 % by nitrendipine (p < 0.01 vs. before treatment) and by 21 +/- 8 % by enalapril (p < 0.05 v s. before treatment). The excretion of alpha1-microglobulin decreased by 35 +/- 10 % and by 39 +/- 9 %, respectively (p < 0.05 vs. before tr eatment). C reatinine clearance rose by 20 +/- 30 % during nitrendipin e treatment (p < 0.05 vs. before treatment) but was unchanged during e nalapril treatment. Total kidney volume decreased by 23 +/- 4 % (p < 0 .01) and by 14 +/- 6 % (p < 0.05), respectively. Blood pressure fell b y 8 +/- 1 % (systolic) and by 13 +/- 1 % (diastolic) in nitrendipine-t reated patients (both p < 0.01) and by 10 +/- 1 % and 13 +/- 1 % in en alapril-treated patients (both p < 0.01). Thus, nitrendipine long-term treatment of microalbuminuric type 1 diabetic appeared to be as effec tive as the treatment with enalapril in preventing or postponing the p rogression of diabetic nephropathy.