Increased glomerular filtration rate after converting-enzyme inhibition in essential hypertension.

Abstract To test the influence of an inhibitor of angiotensin-converting enzyme, teprotide (SQ 20881), we administered it to seven patients with essential hypertension and normal renal function and nine with an unequivocal reduction in creatinine clearance, caused by bilateral renal-artery stenosis in two and by essential hypertension in seven. Despite the fall in blood pressure (112.7±4.5 to 100.3±3.9 mm Hg, mean ± S.E.M., P<0.01), there were prompt increases in both creatinine clearance (95.9±10.5 to 109.9±9.5 ml per minute per 1.73 m2 of body-surface area, P<0.01) and sodium excretion (17.0±5.9 to 31.7±7.2 μmol per minute, P<0.01) in patients with essential hypertension. The increase in glomerular filtration rate was most striking, averaging 33 per cent (66.0±10.3 to 88.0±9.2 ml per minute per 1.73 m2, P<0.001) in patients in whom an initial reduction was evident and hypertension was more severe. These observations suggest that a functional element, perhaps involving angiotensin-mediated renal vasocons...