Je. Moulder et al., TREATMENT OF RADIATION NEPHROPATHY WITH ACE-INHIBITORS, International journal of radiation oncology, biology, physics, 27(1), 1993, pp. 93-99
Citations number
30
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: A previous study showed that radiation nephritis could be tre
ated with captopril, an angiotensin-converting-enzyme inhibitor. These
studies were designed to determine whether other angiotensin-converti
ng-enzyme inhibitors would be effective, whether captopril would inhib
it the development of the histopathologic lesions typical of radiation
nephritis, and whether captopril could be used to treat the nephropat
hy observed in bone marrow transplant recipients conditioned with tota
l body irradiation. Methods and Materials: In radiation nephritis stud
ies, rats were given 17-27 Gy bilateral renal irradiation in 5 fractio
ns. Six months after irradiation animals were stratified by blood urea
nitrogen and assigned to no treatment, or treatment with captopril (5
00 mg/l) or enalapril (50 mg/l) in the drinking water. A subset of ani
mals was sacrificed for histopathology after 3 months; the remaining a
nimals continued on drugs for 7 months. In the bone marrow transplant
nephropathy study, rats received 14-17 Gy total body irradiation in 6
fractions over 3 days followed by syngeneic bone marrow transplant. Si
x months after irradiation, animals were stratified by blood urea nitr
ogen and assigned to no treatment, or treatment with captopril (500 mg
/l). Animals remained on drugs for 6 months. In all studies animals we
re-followed with periodic renal function tests. Results: In the radiat
ion nephritis study, survival and renal function were significantly en
hanced by both captopril and enalapril, but there were no significant
differences between the drugs. The histopathologic severity of the les
ions of radiation nephritis correlated with the degree of renal dysfun
ction; and in irradiated animals with equal initial azotemia, captopri
l-treated rats developed less severe renal lesions. Finally, captopril
also prolonged survival and preserved renal function in this rat bone
marrow transplant nephropathy model. Conclusion: Angiotensin-converti
ng-enzyme inhibitors are an effective treatment for both radiation nep
hritis and bone marrow transplant nephropathy.