Can lisinopril cause kidney damage
Searched over 200M research papers
Research Analysis by Consensus
Beta · 20 papersConsensus Meter
Yes0%
Possibly0%
No0%
Can Lisinopril Cause Kidney Damage?
Introduction to Lisinopril and Kidney Function
Lisinopril is an angiotensin-converting enzyme inhibitor (ACEi) commonly prescribed for hypertension, heart failure, and chronic kidney disease (CKD). While ACE inhibitors are known for their renoprotective effects, concerns about potential kidney damage have been raised. This article synthesizes research findings to address whether lisinopril can cause kidney damage.
Renoprotective Effects of Lisinopril
Slowing Progression of Renal Insufficiency
Several studies have demonstrated that lisinopril can slow the progression of renal insufficiency in patients with chronic kidney disease. For instance, a study on non-diabetic nephropathies found that lisinopril was more effective than other antihypertensive agents in maintaining renal function stability over a 22.5-month period. Similarly, in hypertensive patients with diabetic nephropathy, lisinopril was shown to reduce the rate of decline in kidney function comparably to atenolol, another antihypertensive drug .
Reducing Oxidative Stress and Renal Damage
Lisinopril has also been found to attenuate renal oxidative injury. In a study involving hypertensive rats, lisinopril treatment significantly reduced markers of oxidative stress and renal impairment, suggesting its potential to mitigate hypertension-induced renal damage. Additionally, in a model of unilateral ureteral obstruction in rats, lisinopril was effective in preventing early renal damage and reducing apoptosis in renal tissues.
Impact on Microalbuminuria
Microalbuminuria, an early indicator of kidney damage, can be significantly reduced with lisinopril treatment. In children with sickle cell anemia, lisinopril caused a significant regression of microalbuminuria, indicating its protective effect on kidney function. This effect was also observed in type 1 diabetic patients, where lisinopril reduced albuminuria more effectively than a calcium antagonist, nisoldipine.
Potential Risks and Adverse Effects
Acute Kidney Injury and Other Adverse Effects
Despite its renoprotective benefits, lisinopril can cause acute kidney injury (AKI) in some cases. Common adverse effects include hyperkalemia and angioedema, and there have been rare reports of severe conditions such as necrotizing pancreatitis. The risk of AKI is particularly noted in patients with pre-existing renal conditions or those who experience significant drops in blood pressure.
Genetic Factors Influencing Response
The effectiveness and safety of lisinopril may also be influenced by genetic factors. A study on the ACE gene polymorphism found that patients with different genotypes responded differently to lisinopril treatment. Those with the II genotype showed a more significant reduction in albumin excretion rate compared to other genotypes, suggesting that genetic profiling could help predict the risk of kidney damage and the efficacy of treatment.
Conclusion
Lisinopril generally has a renoprotective effect, slowing the progression of renal insufficiency and reducing oxidative stress and microalbuminuria. However, it can cause acute kidney injury in certain individuals, particularly those with pre-existing renal conditions or specific genetic profiles. While the benefits of lisinopril often outweigh the risks, careful monitoring and individualized treatment plans are essential to minimize potential kidney damage.
Sources and full results
Most relevant research papers on this topic
