THE COMPARISON OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS AND ANGIOTENSIN RECEPTOR ANTAGONISTS IN PATIENTS WITH MODERATE CHRONIC RENAL FAILURE

In this prospective-randomised study, the effects of angiotensin converting enzyme inhibitors (enaiapril) and angiotensin receptor antagonists (losartan) use on various laboratory parameters in 27 patients with moderate chronic renal failure were compared regarding safety and efficacy of both. The follow-up time was 6 month. Thirteen patients (M/F:3/10, mean age:41 ± 15 years) for enaiapril and 14 patients (M/F:4/10, mean age:5J±13 years) for losartan were included. There was no difference for age, gender and primary renal disease between two groups. More significant decrease in systolic blood pressure was observed in enaiapril group (from 142±21 mmHg to 133±23 mmHg, p<0.001) than losartan group (from 153±13 mmHg to 139±13 mmHg, p<0.05). No significant change after treatment was found between study groups. Serum K levels were significantly increased after treatment in enaiapril group (from 4,7±0,6 to 5,4±0,5 mmHg, p<0.05), but no significant change in losartan group was observed. Serum uricacid levels were significantly decreased (from 6.2 ± 1,8 to 5.8 ± 1.6, p=0.01) in losartan group, but no change in enaiapril group was found.

In conclusion, better blood pressure control could be obtained with enaiapril compared to losartan in this group of patients. Deterioration in renal function in both groups were similar. However, serum potassium levels elevated more in the enaiapril group than losartan. Decrease in serum uric acid levels after losartan may be a superiority compare to enaiapril treatment.