P. Vanpaassen et al., RENAL AND SYSTEMIC EFFECTS OF THE RENIN INHIBITOR REMIKIREN IN PATIENTS WITH ESSENTIAL-HYPERTENSION, Journal of cardiovascular pharmacology, 26(1), 1995, pp. 39-45
Remikiren is an orally available renin inhibitor with an established b
lood pressure-lowering effect in patients with essential hypertension.
No data are available on the renal effects of remikiren in humans. We
therefore studied the effects of a single oral administration of remi
kiren on blood pressure and renal function in 16 patients with essenti
al hypertension on a restricted dietary sodium intake. Remikiren induc
ed a peak fall in mean arterial pressure of 8.5 +/- 0.8%. The glomerul
ar filtration rate (GFR) remained stable, whereas the effective renal-
plasma flow rose by 11.3 +/- 1.4%. As a consequence, the filtration fr
action and the renal vascular resistance fell by 11.7 +/- 1.2% and 17.
6 +/- 1.3%, respectively. These systemic and renal hemodynamic changes
were more pronounced in individuals with a higher initial immunoreact
ive renin. Remikiren induced a significant rise in the fractional excr
etion of sodium [0.38% (0.24-0.52) to 0.50% (0.31-0.76)] and lithium [
28.7% (25.0-32.4) to 33.2% (27-39.4)]. Moreover, remikiren induced a d
ecrease in urinary albumin excretion [497 (268-815) to 252 (114-389) m
u g/h]. In patients with essential hypertension, a single oral dose of
remikiren can induce a renal vasodilation, without affecting the GFR
and despite a significant decrease in blood pressure. This systemic an
d renal hemodynamic response is more pronounced in case of a more acti
vated renin-angiotensin system.