Cilazapril delays progression of hypertension and uremia in rat polycystic kidney disease

Polycystic kidney disease (PKD) is the fourth most common cause of end-stage renal disease and is a common cause of hypertension and associated vascular morbidity, Activity of the renin angiotensin system has been identified as a major component of hypertension and altered fluid and electrolyte physiology in PKD, Activity of this pathway also has been proposed as a potential modulator of structural change in both tubules and the interstitium of the kidney, Cilazapril is a long-acting angiotensin-converting enzyme inhibitor that has been effective in producing vascular remodelling in hypertensive vascular disease, We undertook a study to determine whether therapy with cilazapril would modify the expression of PKD in the Han:SPRD-cy rat, a model of autosomal dominant PKD that closely resembles human disease, Male rats were treated for 4 months, starting at 1 month of age, Control animals were hypertensive by 3 months of age, whereas treated animals were noted to be hypertensive only at the exit assessment (P < 0.001 at 3 months, P = 0.005 at 5 months), At 5 months of age, cilazapril-treated animals had modest but statistically significant reductions in serum creatinine (mean, 1.77 mg/dL v 1.97 mg/dl; P = 0.0006) and morphometrically assessed cyst volume (mean, 0.32 mt v 0.67 mt; P = 0.036), Cilazapril is an effective treatment for hypertension in this model of progressive renal disease and may have benefits beyond the prevention of cardiovascular morbidity. (C) 1995 by the National Kidney Foundation, Inc.