James J. Glazier, MD; Jeffrey W. Olin, DO
To the Editors: Toto and colleagues (1) reported a relatively high incidence of reversible renal insufficiency (19%) in patients with hypertensive nephrosclerosis and chronic renal insufficiency treated with enalapril and "conventional" antihypertensive agents. Renal insufficiency was associated only with a significant decrease in blood pressure and did not occur in patients treated with only "conventional" antihypertensive agents. This observation makes sense physiologically and, if confirmed, will make an important contribution to the literature.
A major point of contention is the investigators' proposal that enalapril may cause reversible renal insufficiency in patients with chronic renal parenchymal disease but without renal artery
Glazier JJ, Olin JW. Reversible Renal Insufficiency and Angiotensin-Converting Enzyme Inhibitor Therapy. Ann Intern Med. ;116:697–698. doi: 10.7326/0003-4819-116-8-697
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Published: Ann Intern Med. 1992;116(8):697-698.
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