Je. Moulder et al., RADIATION NEPHROPATHY IS TREATABLE WITH AN ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR OR AN ANGIOTENSIN-II TYPE-1 (AT(1)) RECEPTOR ANTAGONIST, Radiotherapy and oncology, 46(3), 1998, pp. 307-315
Citations number
32
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Background and purpose: Previous studies showed that progression of es
tablished radiation nephropathy could be delayed by continuous treatme
nt with high doses of captopril, an angiotensin-converting-enzyme (ACE
) inhibitor. The current studies were designed to determine whether a
lower dose or a shorter treatment with captopril would be effective an
d whether an angiotensin II type-1 (AT(1)) receptor antagonist (AII bl
ocker) would be effective. Materials and methods: In the captopril stu
dies, rats were given renal irradiation at doses sufficient to produce
radiation nephropathy. Six months after irradiation, animals were str
atified by azotemia and assigned to no treatment, continuous high-or l
ow-dose captopril, or 6 weeks of high-dose captopril. Captopril was gi
ven in drinking water al 62.5 mg/l (low dose) or 500 mg/l (high dose),
The AII blocker study had a similar design, except that the nephropat
hy was the result of total body irradiation and bone marrow transplant
ation and the treatments were no treatment or continuous treatment wit
h an AII blocker, L-158,809 (20 mg/l in drinking water). Animals were
followed for 1 year with periodic studies of renal function. Results:
Survival and renal function were significantly enhanced by all treatme
nts. Continuous captopril treatment was more effective than the 6-week
course of treatment, but there was no difference in effectiveness bet
ween the high and low doses of captopril. In continuous therapy, capto
pril and the AII blocker had roughly equivalent efficacy. Conclusions:
Both the ACE inhibitor and the AII blocker were effective treatments
for established radiation nephropathy. The best results with the ACE i
nhibitor required continuous therapy, but could be achieved with a low
dose of the drug. (C) 1998 Elsevier Science Ireland Ltd.