Summary
When choosing antihypertensive agents for the treatment of hypertension, it is necessary to consider the predisposition of individuals to renal damage, which may be associated with the long-term effect of such agents. In this respect, this study examined the effect of two commonly used antihypertensive drugs (Brinerdin and Minizide) on renal function over 24 months in patients diagnosed as having essential hypertension. We utilized urinary enzyme studies, which are indicators of subtle renal dysfunction. Other parameters of glomerular and tubular function were also determined in the pretreatment period, as well as during and at the end of treatment of 28 patients (16 males and 12 females) with therapeutic doses of Brinerdin and 22 patients (12 males and 10 females) with conventional doses of Minizide. During the follow-up period, blood pressure (BP) fell from a mean of 160/108±9/4 (SD) mmHg to 130/90±7/4 on Brinerdin and from a mean of 160/106±5/2 (SD) mmHg to 130/90±8/5 on Minizide. There was no significant difference in the levels of BP between the patients taking Minizide and those taking Brinerdin before, during, and at the end of treatment. Significant elevation (p<0.05) of the levels of urinary protein, lactate dehydrogenase (LDH), and N-acetyl-B-D-glycosaminidase (NAG) was observed in patients on Minizide during treatment, and these levels remained elevated during the latter part of the study. Normotensive, untreated, age-and sex-matched control subjects showed no such urinary parameter changes. While NAG activity was significantly elevated in the Brinerdin-treated patients, other parameters remained within comparable levels to those of normotensive, untreated control subjects throughout the period of study. However, a significant reduction in the serum potassium level (−0.58±0.06 mmol/l) was observed following Minizide therapy compared with a mild reduction (−0.25±0.05 mmol/l) following Brinerdin treatment. Female and male patients exhibited similar patterns of response to the two drugs. The results of the present study suggest that transient but subtle tubular injury has been induced by the use of the two drugs with a more profound effect from the use of Minizide.
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Obatomi, D.K., Mogbo, S.C.J., Anjorin, F.I. et al. Changes in urinary enzyme levels following the use of antihypertensive agents in patients with essential hypertension. Cardiovasc Drug Ther 9, 407–412 (1995). https://doi.org/10.1007/BF00879029
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DOI: https://doi.org/10.1007/BF00879029