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      Ramipril Reduces Advanced Glycation End Products In Non-Diabetic Nephropathy

      A DGReview of :"Effects of ramipril in nondiabetic nephropathy: improved parameters of oxidatives stress and potential modulation of advanced glycation end products"
      Journal of Human Hypertension

      04/21/2003
      By Mark Greener


      Ramipril produces a mild reduction in levels of advanced glycation end products, perhaps reflecting decreased oxidative stress, in patients with mild-to-moderate non-diabetic nephropathy.

      Researchers from the Institute of Preventive and Clinical Medicine and the Military Hospital, Bratislava, Slovakia, as well as the University Wuerzburg, Germany, enrolled 12 patients with newly diagnosed mild-to-moderate non-diabetic nephropathy, who received ramipril for two months. A group of non-diabetic nephropathy patients taking diuretics and beta-blockers were also enrolled as were as age- and sex-matched healthy controls.

      Compared to controls, patients with non-diabetic nephropathy showed higher levels of advanced glycation end products, carboxymethyllysine, advanced oxidation protein products, lipofuscin and homocysteine as well as mild-to-moderate renal insufficiency. In general, the baseline characteristics of patients taking diuretics and beta-blockers did not differ from those in the ramipril group. However, homocysteine levels were higher in the ramipril group.

      Ramipril reduced blood pressure and proteinuria, while creatinine clearance did not alter. Ramipril also mildly decreased levels of advanced glycation end products, while concentrations of advanced oxidation protein products and malondialdehyde declined.

      This offers the first evidence that ramipril reduces levels of advanced glycation end products. The decline in advanced oxidation protein products and malondialdehyde suggests a reduction in oxidative stress.

      Carboxymethyllysine concentrations did not change and neopterin concentrations slightly increased following ramipril. Conventional treatment with diuretics and beta-blockers did not significantly alter these parameters.
      Journal of Human Hypertension 2003;17:265-270. "Effects of ramipril in nondiabetic nephropathy: improved parameters of oxidatives stress and potential modulation of advanced glycation end products"

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