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EFFICACY AND SAFETY OF RAMIPRIL IN HYPERTENSIVE SINGLE‐KIDNEY PATIENTS

The effects of medium-term antihypertensive treatment with the ACE inhibitor ramipril were studied on 10 hypertensive single-kidney patients in a double-blind study versus placebo. Patients with renovascular hypertension were excluded. Compared to placebo, ramipril induces a significant reduction of arterial blood pressure (p < 0.02 for systolic, p < 0.01 for diastolic, and p < 0.05 for mean blood pressure), renal vascular resistance (p < 0.005), and microalbuminuria (p < 0.005), but a significant rise of effective renal plasma flow (p < 0.01) and no significant variation of the glomerular filtration rate. The reduction of microalbuminuria was not related to arterial blood pressure variation. Our study shows that ramipril, in appropriately selected single-kidney patients, is effective and safe in reducing arterial blood pressure, bringing about an improvement of renal function and reducing microalbuminuria, which is frequently observed in this condition.