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. 2011 Mar;9(1):67-71.
doi: 10.1016/j.aju.2011.03.016. Epub 2011 May 6.

Recoverability of renal function after relief of chronic partial unilateral ureteric obstruction: The effect of an angiotensin-converting enzyme inhibitor (enalapril)

Shady A Soliman  1 , Ahmed A Shokeir  1 , Ahmed Mosbah  1 , Hassan Abol-Enein  1 , Nashwa Barakat  1 , Essam Abou-Bieh  1 , Ehab W Wafa  1
Affiliations

Recoverability of renal function after relief of chronic partial unilateral ureteric obstruction: The effect of an angiotensin-converting enzyme inhibitor (enalapril)

Shady A Soliman et al. Arab J Urol. 2011 Mar.

Abstract

Objectives: We evaluated the effect of an angiotensin-converting enzyme inhibitor (enalapril) on renal function during and after the relief of partial unilateral ureteric obstruction (UUO).

Materials and methods: Thirty-two male mongrel dogs were classified into three groups: sham (eight), control (12; left partial UUO + no medication) and study (12; left partial UUO + enalapril). Dogs in the study and control groups were subjected to 4 weeks of partial UUO. After that, the dogs were re-opened and subjected to Lich-Gregoir vesico-ureteric re-implantation, and were killed humanely by the end of the eighth week after relief of obstruction. The study and control groups were evaluated at baseline, after 4 weeks of obstruction and at 4 and 8 weeks after relief of obstruction, by measuring selective creatinine clearance (CCr), selective renographic clearance (RCr) and renal resistive index (RI). The sham group had sham surgery at 4 and 8 weeks and was evaluated as the other two groups.

Results: Sham surgery showed no significant effect on any of the evaluated variables. Compared with the control, enalapril offset the reductions of CCr and RCr by an extra 11% and 12% of the basal values by the end of the fourth week of obstruction, respectively. Moreover, compared with the control, enalapril enhanced the recovery of CCr by an extra 10% and of RCr by an extra 23% of the basal values at 8 weeks after relief of the 4-week obstruction. In addition, the increase in RI was significantly less in the enalapril group.

Conclusion: Enalapril decreases the deterioration of renal function in partial UUO and enhances the recoverability of renal function after relief of obstruction.

Keywords: (U)UO, (unilateral) ureteric obstruction; ACE, angiotensin-converting enzyme; CCr, creatinine clearance; DUS, Doppler ultrasonography; Enalapril; RAS, renin-angiotensin system; RCr, renographic clearance; RI, resistive index; Recoverability of renal function; Ureteric obstruction.

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Figures

Figure 1
Figure 1
Changes in the CCr of the left kidney after 4 weeks of UO and 8 weeks after relief of UO in the control and enalapril groups, and in the sham group at baseline, 4 and 8 weeks after sham surgery (P1 = enalapril vs control vs sham; P2 = enalapril vs control).
Figure 2
Figure 2
Changes in the split RCr of the left kidney after 4 weeks of UO, and 4 and 8 weeks after relief of UO in the enalapril and control groups, and in the sham group at baseline, 4 and 8 weeks after sham surgery (P1 = enalapril vs control vs sham; P2 = enalapril vs control).
Figure 3
Figure 3
Changes in the renal RI of the left kidney after 4 weeks of UO, and 4 and 8 weeks after relief of UO in the enalapril and control groups, and in the sham group at baseline, 4 and 8 weeks after sham surgery (P = enalapril vs control).
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