EFFECTS OF ENALAPRIL AND NITRENDIPINE ON THE EXCRETION OF EPIDERMAL GROWTH-FACTOR AND ALBUMIN IN HYPERTENSIVE NIDDM PATIENTS

OBJECTIVE- To compare the effect of the antihypertensive drugs nitrend ipine and enalapril on the excretion of epidermal growth factor (EGF) and albumin in hypertensive non-insulin-dependent diabetes mellitus (N IDDM) subjects. RESEARCH DESIGN AND METHODS- After a 4-week washout pe riod, mildly hypertensive (systolic blood pressure [sBP] greater than or equal to 140 mmHg and/or diastolic blood pressure [dBP] greater tha n or equal to 90 mmHg) NIDDM patients with albuminuria (15-200 mu g/mi n) were randomized into an 8-month-long therapy with either nitrendipi ne (n = 11) or enalapril (n = 10). Blood pressure, EGF, and microalbum in excretion were measured at baseline and throughout the treatment pe riod. RESULTS- A significant fall in sBP was noticed in the enalapril group and in dBP in the nitrendipine group. In the enalapril group, EG F excretion progressively increased from 188 to 214 nmol/mmol creatini ne after 6 weeks and to 274 after 8 months of therapy (P = 0.03). Ther e was a significant fall in albumin excretion while patients were on e nalapril, but in the nitrendipine group, neither albuminuria nor EGF e xcretion changed significantly. There was no correlation of improved E GF excretion with a decrease in albuminuria or BP. CONCLUSIONS- The an giotensin-converting enzyme inhibitor enalapril has been effective in decreasing albumin and increasing EGF excretion. Measurement of urinar y EGF may provide a new valuable index of renal function.