COMPARISON OF EFFECTS OF ACE-INHIBITION WITH CALCIUM-CHANNEL BLOCKADEON RENAL-DISEASE IN A MODEL COMBINING GENETIC-HYPERTENSION AND DIABETES

The aim of this study was to compare the renal effects of angiotensin converting enzyme (ACE) inhibition with calcium channel blockade in a model combining genetic hypertension with diabetes. Streptozotocin dia betes was induced in spontaneously hypertensive rats (SHR). The animal s were then randomized to receive no treatment, the ACE inhibitor, per indopril, or the dihydropyridine calcium antagonist lacidipine. Body w eight, systolic blood pressure, glycemic control, renal function, and albumin excretion rate (AER) were assessed serially over the 32-week s tudy period. At week 32 the animals; were killed and glomerular volume was measured. Both antihypertensive regimens significantly reduced sy stolic blood pressure in diabetic SHR. There was no significant differ ence in glycemic control, serum creatinine, or glomerular filtration r ate among the three groups at week 32. The ACE inhibitor perindopril s ignificantly reduced AER and glomerular hypertrophy over the 32 weeks, whereas the calcium antagonist lacidipine failed to reduce AER or glo merular hypertrophy. Thus, in contrast to the effects of ACE inhibitio n, calcium channel blockade with lacidipine, despite significantly red ucing blood pressure, failed to reduce renal injury in this model. The se results support the hypothesis that antihypertensive regimens may d iffer in their capacity to protect the diabetic kidney, despite simila r effects on systemic blood pressure.