Angiotensin converting enzyme inhibitor administration for preventing CAN

Objective: To observe whether enalapril,a specific angiotensin converting enzyme inhibitor,has a role in preventing chronic allograft nephropathy（CAN）.Methods: From January 1,2000 to July 30 twenty-five renal transplant recipients whose urine TGF-β₁ concentration were higher than 250.0 pg/mg·Cr with normal renal function began angiotensin converting enzyme inhibitor（enalapril） therapy one year after surgery were studied as Group A.Each patient in Group A took 5mg enalapril every day for at least one year.Twenty-three recipients who never received angiotensin converting enzyme inhibitor were studied as Group B in the same fashion.Side-effects for takeing enalapril were investigated in all patients in Group A.intensions of TGF-β₁ immunofluorescence in renal grafts were compared between before and 1 year after enalapril therapy in Group A.3 years after initiation of enalapril,renal function and blood and urine TGF-β₁ concentration were compared between the two groups.（Results: Ccr） decreased faster in Group B than Group A.Three years later,Ccr had been lost for 5.0±4.4（ml/min） and there were 2 recepients with CAN in group A,but Group B had lost 13.7±9.5（ml/min） in Ccr and showed 9 recepients with CAN.There were significantly more loss of renal function and more number of CAN cases in group B than group A.Urine TGF-β₁ Ccr had Ccr had been lost for 5.0±4.4（ml/min） and there were 2 recepients with CAN in group A,but Group B had lost 13.7±（9.5（ml/min）） in Ccr and showed 9 recepients with CAN.There were significantly more loss of renal function and more number of CAN cases in group B than group A.Urine TGF-β₁ concentrations were 324.7±46.2 and 507.7±53.1（pg/mg·Cr） in group A and B respectively 3 years after initiation of enalapril.It was significantly higher in group A than group B.The values of blood TGF-β₁ concentration did not reveal any significant difference between the two groups.One year after enalapril therapy intensions of TGF-β₁ immunofluorescence in Group A significantly decreased from 10.95±2.31(×10⁶) to 6.37±1.50(×10⁶).No side-effects were noted in all patients who had taken enalapril.Conclusions: Enalapril can prevent chronic allograft nephropathy（CAN） in renal transplant recipients through reducing TGF-β₁secretion in the kidney.kidney transplantation;nephropathy;enalapril;TGF