Effects of enalapril versus placebo as a treatment for canine idiopathic glomerulonephritis

A blinded, multicenter, prospective clinical trial assessed the effects of enalapril (EN) versus standard care in dogs with naturally occurring, idiop athic glomerulonephritis (GN). Twenty-nine adult dogs with membranous (n = 16) and membranoproliferative (n = 13) GN were studied. Dogs were randomly assigned to receive either EN (0.5 mg/kg PO q12-24h; n = 16) or placebo (n = 14) for 6 months (1 dog was treated first with the placebo and then with EN. All dogs were treated with low-dose aspirin (0.5-5 mg/kg RO q12-24h) an d fed a commercial diet. At baseline, serum creatinine (SrCr), systolic blo od pressure (SBP), and glomerular histologic grade were not different betwe en groups, but the urine protein/creatinine ratio (UP/C) was greater in the EN group compared with the placebo group (8.7 +/- 4.4 versus 4.7 +/- 2.3). After 6 months of treatment, the change in UP/C from baseline was signific antly different between groups (EN = -4.2 +/- 1.4 versus 1.9 +/- 0.9 in the placebo group). When data were adjusted for changes in SrCr (SrCr x UP/C) a similar significant reduction was noted (-2.2 +/- 15.2 versus 8.4 +/- 10. 1). The change in SEP after 6 months of treatment also was significantly di fferent between groups (EN = -12.8 +/- 27.3 versus 5.9 +/- 21.5 mm Hg in th e placebo group). Response to treatment was categorized as improvement (ass igned a value of 2), no progression (assigned a value of 1), and progressio n (assigned a value of 0). Response was significantly better in the EN grou p (1.4 +/- 0.8) compared with the placebo group (0.3 +/- 0.5). These result s suggest that EN treatment is beneficial in dogs with naturally occurring idiopathic GN.