benazepril and Renal-Insufficiency--Chronic

Chronic kidney disease (CKD) is an important cause of morbidity and mortality in dogs.. To evaluate the efficacy in prolonging survival and safety of benazepril administration to dogs with CKD.. Forty-nine client-owned dogs with CKD.. Dogs were randomized to benazepril (0.25 to <0.5 mg/kg) or placebo once daily for up to 2 years in a prospective, multicenter, blinded clinical trial. The primary endpoint variable was the renal survival time, defined as the time from inclusion in the study to the treatment failure endpoint of death or euthanasia or need for administration of parenteral fluids related to renal failure.. No benefit of benazepril versus placebo was detected for renal survival time in all dogs; median (95% confidence interval (CI)) survival times were 305 (53-575) days in the benazepril group and 287 (152-not available) in the placebo group (P = .53). Renal survival times were not significantly longer with benazepril compared to placebo for subgroups: hazard ratios (95% CI) were 0.50 (0.21-1.22) with P = .12 for initial urine protein-to-creatinine ratio (UPC) >0.5, and 0.38 (0.12-1.19) with P = .080 for initial UPC >0.5 plus plasma creatinine ≤440 μmol/L. Proteinuria, assessed from the UPC, was significantly (P = .0032) lower after treatment with benazepril compared to placebo. There were no significant differences between groups for clinical signs or frequencies of adverse events.. Benazepril significantly reduced proteinuria in dogs with CKD. Insufficient numbers of dogs were recruited to allow conclusions on survival time.

Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Benzazepines; Dog Diseases; Dogs; Female; Male; Renal Insufficiency, Chronic; Single-Blind Method; Treatment Outcome

An altered ambulatory blood pressure (BP) and heart rate (HR) profile is related to chronic kidney disease (CKD) and cardiorenal syndrome. In this study, we examined the effects of aliskiren, when added to angiotensin II type 1 receptor blockers, on ambulatory BP and cardiorenal function in CKD. Thirty-six hypertensive CKD patients were randomly assigned to the aliskiren add-on group (n = 18) or the benazepril add-on group (n = 18). Ambulatory BP and cardiorenal function parameters were measured at baseline and 24 weeks after treatment. Compared with the benazepril group, nighttime systolic BP variability in the aliskiren group was lower after treatment. Albuminuria was decreased in the aliskiren group, but not in the benazepril group. In addition, left ventricular mass index (LVMI) was significantly lower in the aliskiren group than in the benazepril group after treatment. In the aliskiren group, multivariate linear regression analysis showed an association between changes in albuminuria and changes in nighttime systolic BP. Furthermore, there were associations between changes in LVMI and changes in daytime HR variability, as well as between changes in LVMI and changes in plasma aldosterone concentration. These results suggest that aliskiren add-on therapy may be beneficial for suppression of renal deterioration and pathological cardiac remodeling through an improvement that is effected in ambulatory BP and HR profiles.

Topics: Aged; Albuminuria; Amides; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Benzazepines; Blood Pressure; Cardio-Renal Syndrome; Female; Fumarates; Heart Function Tests; Heart Rate; Humans; Hypertrophy, Left Ventricular; Kidney Function Tests; Male; Oxidative Stress; Renal Insufficiency, Chronic

To observe the clinical efficiency and safety of Benazepril and wind dispelling and dampness removing Chinese herbs were singly or combined used in patients with stage 3 chronic kidney disease (CKD 3), and to provide effective integrative medicine methods for treatment of CKD 3.. The CKD 3 was allocated to qi and yin deficiency syndrome, inner disturbance of wind and damp syndrome, stasis in Shen meridian syndrome, and inner accumulation of damp and heat syndrome. Recruited were patients of inner disturbance of wind and damp syndrome accompanied or unaccompanied with the other 3 syndrome types. In the prospective, randomized, double blind controlled study, 60 patients confirmed as primary chronic glomerulonephritis (CGN) were randomly assigned to 3 groups with a total course of treatment for 24 weeks. Patients in the Western medicine group (WM, 23 cases) took Benazepril (10 mg/d). Those in the Chinese medicine group (CM, 20 cases) received treatment by syndrome typing. Those in the combination group (17 cases) used the two methods. The therapeutic efficacy and the occurrence of adverse reactions were observed in the 3 groups.. The inner disturbance of wind and damp syndrome accompanied qi and yin deficiency syndrome and stasis in Shen meridian syndrome was most often seen in these patients. It accounted for 75.0% in the CM group, 60.9% in the WM group, and 82.4% in the combination group. Totally 54 patients completed this trial. Of them, there were 19 in the CM group, 19 in the WM group, and 16 in the combination group. There was no significant difference in the total effective rate of Chinese medicine syndrome among the 3 groups (84.2%, 78.9%, and 87.5%, respectively) (P>0.05). As for the total effective rate of WM, it was obviously higher in the combination group than in the WM group and the CM group (100.0%, 94.7%, and 94.7%, respectively) (P<0.05). The ratio (24 weeks of treatment/pre-treatment ratio) of serum creatinine (SCr) was obviously higher in the WM group than in the combination group (P<0.05), the estimate glomerular filtration rate (eGFR) (24 weeks of treatment/pre-treatment ratio) was obviously lower in the WM group than in the combination group (P<0.05). There was no statistical difference in SCr and eGFR between the CM group and the combination group. The mean and median of 24 h urine protein ratio (24 weeks of treatment/pre-treatment ratio) were less in the combination group than in the other two groups. The urine protein greater than 2.0 g/d occurred in no case. The experimental drug-correlated adverse reaction rate was obviously higher in the WM group than in the CM group (30.4% vs 10.0%, P<0.05).. As for CGN CKD 3 patients, treatment by Benazepril combined with wind dispelling and dampness removing Chinese herbs showed favorable renal protective effects. It delayed the progress of renal failure, significantly improve the overall clinical efficacy. It was an effective treatment method for CGN CKD 3 patients with good patient tolerance and less adverse reactions.

Topics: Adult; Benzazepines; Double-Blind Method; Drug Therapy, Combination; Drugs, Chinese Herbal; Female; Humans; Male; Medicine, Chinese Traditional; Middle Aged; Phytotherapy; Prospective Studies; Renal Insufficiency, Chronic; Yin Deficiency

The Renoprotection of Optimal Antiproteinuric Doses (ROAD) study was performed to determine whether titration of benazepril or losartan to optimal antiproteinuric doses would safely improve the renal outcome in chronic renal insufficiency. A total of 360 patients who did not have diabetes and had proteinuria and chronic renal insufficiency were randomly assigned to four groups. Patients received open-label treatment with a conventional dosage of benazepril (10 mg/d), individual uptitration of benazepril (median 20 mg/d; range 10 to 40), a conventional dosage of losartan (50 mg/d), or individual uptitration of losartan (median 100 mg/d; range 50 to 200). Uptitration was performed to optimal antiproteinuric and tolerated dosages, and then these dosages were maintained. Median follow-up was 3.7 yr. The primary end point was time to the composite of a doubling of the serum creatinine, ESRD, or death. Secondary end points included changes in the level of proteinuria and the rate of progression of renal disease. Compared with the conventional dosages, optimal antiproteinuric dosages of benazepril and losartan that were achieved through uptitration were associated with a 51 and 53% reduction in the risk for the primary end point (P = 0.028 and 0.022, respectively). Optimal antiproteinuric dosages of benazepril and losartan, at comparable BP control, achieved a greater reduction in both proteinuria and the rate of decline in renal function compared with their conventional dosages. There was no significant difference for the overall incidence of major adverse events between groups that were given conventional and optimal dosages in both arms. It is concluded that uptitration of benazepril or losartan against proteinuria conferred further benefit on renal outcome in patients who did not have diabetes and had proteinuria and renal insufficiency.

Topics: Adult; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Benzazepines; Dose-Response Relationship, Drug; Female; Humans; Hypertension, Renal; Losartan; Male; Middle Aged; Proteinuria; Renal Insufficiency, Chronic; Treatment Outcome

Angiotensin-converting-enzyme inhibitors provide renal protection in patients with mild-to-moderate renal insufficiency (serum creatinine level, 3.0 mg per deciliter or less). We assessed the efficacy and safety of benazepril in patients without diabetes who had advanced renal insufficiency.. We enrolled 422 patients in a randomized, double-blind study. After an eight-week run-in period, 104 patients with serum creatinine levels of 1.5 to 3.0 mg per deciliter (group 1) received 20 mg of benazepril per day, whereas 224 patients with serum creatinine levels of 3.1 to 5.0 mg per deciliter (group 2) were randomly assigned to receive 20 mg of benazepril per day (112 patients) or placebo (112 patients) and then followed for a mean of 3.4 years. All patients received conventional antihypertensive therapy. The primary outcome was the composite of a doubling of the serum creatinine level, end-stage renal disease, or death. Secondary end points included changes in the level of proteinuria and the rate of progression of renal disease.. Of 102 patients in group 1, 22 (22 percent) reached the primary end point, as compared with 44 of 108 patients given benazepril in group 2 (41 percent) and 65 of 107 patients given placebo in group 2 (60 percent). As compared with placebo, benazepril was associated with a 43 percent reduction in the risk of the primary end point in group 2 (P=0.005). This benefit did not appear to be attributable to blood-pressure control. Benazepril therapy was associated with a 52 percent reduction in the level of proteinuria and a reduction of 23 percent in the rate of decline in renal function. The overall incidence of major adverse events in the benazepril and placebo subgroups of group 2 was similar.. Benazepril conferred substantial renal benefits in patients without diabetes who had advanced renal insufficiency. (ClinicalTrials.gov number, NCT00270426.)

Topics: Adult; Aged; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Benzazepines; Blood Pressure; China; Creatinine; Disease Progression; Double-Blind Method; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Proteinuria; Renal Insufficiency, Chronic

We compared the natural multicomponent, multitarget therapy SUC (Solidago compositum ad us. vet., Ubichinon compositum and Coenzyme compositum, Heel GmbH, Baden-Baden, Germany) to the well-known angiotensin-converting enzyme inhibitor benazepril in a prospective, observational, nonrandomized, two-arm cohort study of cats with chronic kidney disease (CKD). The objective was to assess the tolerability and the effectiveness of SUC in cats with CKD.. One hundred thirty-six cats were screened for CKD, and 70 cats were eligible for the study. Thirty-three cats were assigned to the SUC treatment, and 35 cats received benazepril. All cats were diagnosed with CKD. The follow-up period was 168 days. Response was assessed as an improved or stable serum creatinine from baseline to the end of the study. Additionally, a clinical summary score, as measure of quality of life, was evaluated.. Serum creatinine remained close to baseline in both study groups with slightly improved values in the SUC group. The clinical summary score improved significantly in the SUC group on days 3, 7, 28, 56 and 112, but not on day 168.. Within the limitations of the study, the results carry implications for the usefulness of SUC as an interesting new treatment option for feline CKD. The results indicate that SUC might be more effective if given at least twice weekly.. Hintergrund: Es wurde die Multicomponent-Multitarget-Therapie SUC (Solidago compositum ad us. vet., Ubichinon compositum und Coenzym compositum, Heel GmbH, Baden-Baden, Deutschland) mit dem bekannten Angiotensin-Converting-Enzym-Inhibitor (ACEI) Benazepril in einer prospektiven, nichtrandomisierten, zweiarmigen Kohortenstudie an Katzen mit chronischer Nierenerkrankung (CNE) untersucht. Ziel war es, die Verträglichkeit und Wirksamkeit von SUC bei Katzen mit CNE zu beurteilen. Material und Methoden: Einhundertsechsunddreißig Katzen mit Verdacht auf CNE wurden untersucht, bei 70 Katzen wurde eine CNE diagnostiziert und diese wurden in die Studie aufgenommen. Dreiunddreißig Katzen wurden mit SUC therapiert und 35 Katzen erhielten Benazepril. Der Beobachtungszeitraum betrug 168 Tage. Das Ansprechen auf die Therapie wurde definiert als ein verbessertes bzw. ein stabiles Serumkreatinin am Ende der Studie im Vergleich zum Ausgangswert. Zusätzlich wurde zur Bewertung der Lebensqualität der Katzen ein klinischer Summenscore erfasst. Ergebnisse: Das Kreatinin blieb in beiden Studiengruppen nahezu unverändert, mit geringgradig niedrigeren Werten in der SUC-Gruppe. Der klinische Summenscore verbesserte sich in der SUC-Gruppe im Vergleich zur Benazepril-Gruppe signifikant an den Tagen 3, 28, 56 und 112, nicht aber am Tag 168. Schlussfolgerungen: Die Ergebnisse zeigen, dass SUC eine neuartige und gut verträgliche Behandlungsalternative zu ACEIs bei Katzen mit leichter bis mittelschwerer CNE darstellt. Die Ergebnisse deuten darauf hin, dass eine zweimal wöchentliche Therapie mit SUC effektiver sein könnte als eine Dosierung einmal pro Woche.

Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Benzazepines; Cat Diseases; Cats; Female; Male; Prospective Studies; Renal Insufficiency, Chronic

Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Creatinine; Drug Therapy, Combination; Humans; Hyperkalemia; Renal Insufficiency, Chronic

Topics: Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Blood Pressure; Diet, Sodium-Restricted; Humans; Patient Compliance; Renal Insufficiency, Chronic