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Treatments with losartan or enalapril are equally sensitive to deterioration in renal function from cyclooxygenase inhibition.

Juhlin, Tord LU ; Erhardt, Leif RW LU ; Ottosson, Helene LU ; Jönsson, Bo A LU and Höglund, Peter LU (2007) In European Journal of Heart Failure 9(2). p.191-196
Abstract
Background: The beneficial effects of angiotensin converting enzyme (ACE)-inhibitors are in part mediated through the inhibition of the degradation of the vasodilator bradykinin. The bradykinin effect is counteracted by cyclooxygenase-inhibitors. Angiotensin receptor blockers (ARBs) do not affect bradykinin. Aims: To test the hypothesis that renal counteraction from a cyclooxygenase-inhibitor, diclofenac, is different in subjects treated with an ACE-inhibitor, enalapril compared with an ARB, losartan. Methods: Twelve elderly, healthy, slightly over-hydrated subjects received diclofenac orally after pre-treatment with a diuretic, bendroflumethiazide, and enalapril or bendroflumethiazide and losartan, in a double-blind cross-over fashion,... (More)
Background: The beneficial effects of angiotensin converting enzyme (ACE)-inhibitors are in part mediated through the inhibition of the degradation of the vasodilator bradykinin. The bradykinin effect is counteracted by cyclooxygenase-inhibitors. Angiotensin receptor blockers (ARBs) do not affect bradykinin. Aims: To test the hypothesis that renal counteraction from a cyclooxygenase-inhibitor, diclofenac, is different in subjects treated with an ACE-inhibitor, enalapril compared with an ARB, losartan. Methods: Twelve elderly, healthy, slightly over-hydrated subjects received diclofenac orally after pre-treatment with a diuretic, bendroflumethiazide, and enalapril or bendroflumethiazide and losartan, in a double-blind cross-over fashion, with a wash-out period of at least 1 week. Results: Diclofenac reduced GFR significantly from 81(64-98) ml/min at first observations after dose for enalapril to 29(16-42) and from 76 (64-88) afler losartan to 35(24-46). There was no significant difference between enalapril and losartan in GFR. Diclofenac induced decreases in urine flow, excretion rates and clearances of sodium, osmolality clearance and free water clearance, irrespective of treatment with enalapril or losartan. However, serum potassium and handling of potassium were significantly lower after losartan-treatment. Conclusion: The negative renal effects of diclofenac administration in subjects with activation of the renin-angiotensin system and enalapril treatment are the same in subjects with activation of the renin-angiotensin system and losartan treatment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Heart Failure
volume
9
issue
2
pages
191 - 196
publisher
Elsevier
external identifiers
  • wos:000245310700016
  • scopus:33847794819
ISSN
1879-0844
DOI
10.1016/j.ejheart.2006.05.015
language
English
LU publication?
yes
id
3f3ebba0-5125-4fd3-8565-1f9361ce5a29 (old id 158865)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16859993&dopt=Abstract
date added to LUP
2007-07-05 11:26:29
date last changed
2017-05-28 03:32:11
@article{3f3ebba0-5125-4fd3-8565-1f9361ce5a29,
  abstract     = {Background: The beneficial effects of angiotensin converting enzyme (ACE)-inhibitors are in part mediated through the inhibition of the degradation of the vasodilator bradykinin. The bradykinin effect is counteracted by cyclooxygenase-inhibitors. Angiotensin receptor blockers (ARBs) do not affect bradykinin. Aims: To test the hypothesis that renal counteraction from a cyclooxygenase-inhibitor, diclofenac, is different in subjects treated with an ACE-inhibitor, enalapril compared with an ARB, losartan. Methods: Twelve elderly, healthy, slightly over-hydrated subjects received diclofenac orally after pre-treatment with a diuretic, bendroflumethiazide, and enalapril or bendroflumethiazide and losartan, in a double-blind cross-over fashion, with a wash-out period of at least 1 week. Results: Diclofenac reduced GFR significantly from 81(64-98) ml/min at first observations after dose for enalapril to 29(16-42) and from 76 (64-88) afler losartan to 35(24-46). There was no significant difference between enalapril and losartan in GFR. Diclofenac induced decreases in urine flow, excretion rates and clearances of sodium, osmolality clearance and free water clearance, irrespective of treatment with enalapril or losartan. However, serum potassium and handling of potassium were significantly lower after losartan-treatment. Conclusion: The negative renal effects of diclofenac administration in subjects with activation of the renin-angiotensin system and enalapril treatment are the same in subjects with activation of the renin-angiotensin system and losartan treatment.},
  author       = {Juhlin, Tord and Erhardt, Leif RW and Ottosson, Helene and Jönsson, Bo A and Höglund, Peter},
  issn         = {1879-0844},
  language     = {eng},
  number       = {2},
  pages        = {191--196},
  publisher    = {Elsevier},
  series       = {European Journal of Heart Failure},
  title        = {Treatments with losartan or enalapril are equally sensitive to deterioration in renal function from cyclooxygenase inhibition.},
  url          = {http://dx.doi.org/10.1016/j.ejheart.2006.05.015},
  volume       = {9},
  year         = {2007},
}