Does lisinopril help kidneys
Pro Research Analysisby 
Searched over 200M research papers
The Impact of Lisinopril on Kidney Function
Introduction to Lisinopril and Kidney Health
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for managing hypertension and heart failure. Its potential benefits for kidney function, particularly in patients with diabetic nephropathy and other chronic kidney diseases, have been the subject of extensive research. This article synthesizes findings from multiple studies to evaluate whether lisinopril helps protect kidney function.
Lisinopril and Diabetic Nephropathy
Blood Pressure Control and Kidney Function
Several studies have compared the effects of lisinopril with other antihypertensive agents like atenolol in patients with diabetic nephropathy. These studies consistently show that while both drugs effectively reduce blood pressure, lisinopril has a more pronounced effect on reducing albuminuria, a marker of kidney damage. For instance, one study found that lisinopril reduced albuminuria by 55%, compared to 15% with atenolol, indicating a significant renoprotective effect 12.
Long-Term Kidney Function Preservation
In a long-term study, lisinopril was shown to slow the decline in glomerular filtration rate (GFR) in patients with diabetic nephropathy. Although the initial decline in GFR was similar between lisinopril and atenolol groups, the sustained reduction in albuminuria with lisinopril suggests better long-term kidney protection 12.
Lisinopril in Non-Diabetic Kidney Diseases
Chronic Renal Insufficiency
Lisinopril has also been studied in patients with non-diabetic chronic renal diseases. In a study involving patients with mild proteinuria, lisinopril was more effective than other antihypertensive agents in slowing the progression of renal insufficiency. The study reported a significant difference in the decline of inulin clearance, a measure of kidney function, favoring lisinopril over conventional therapy 6.
Renal Transplant Recipients
In renal transplant recipients, lisinopril has been shown to reduce proteinuria and stabilize graft function. One study found that lisinopril significantly decreased proteinuria and improved renal plasma flow without adversely affecting GFR, suggesting its potential benefit in managing post-transplant hypertension and preserving graft function 78.
Combination Therapy and Safety Concerns
ACE Inhibitors and ARBs
Combining ACE inhibitors like lisinopril with angiotensin-receptor blockers (ARBs) has been explored for enhanced renoprotection. However, a study on combination therapy with lisinopril and losartan in diabetic nephropathy patients was halted early due to safety concerns, including increased risks of hyperkalemia and acute kidney injury. This highlights the need for careful monitoring and consideration of potential adverse effects when using combination therapy 5.
Experimental Models and Additional Benefits
Animal Studies
Animal studies have further elucidated the benefits of lisinopril. In a rat model of chronic kidney disease, lisinopril, alone or combined with exercise, significantly ameliorated biochemical and histopathological signs of kidney damage. These findings suggest that lisinopril may offer additional nephroprotection when combined with lifestyle interventions 9.
Polycystic Kidney Disease
In models of autosomal recessive polycystic kidney disease, chronic lisinopril treatment reduced markers of cell proliferation and apoptosis, leading to decreased cyst development and proteinuria. This indicates that lisinopril may beneficially alter disease progression pathways in polycystic kidney disease 10.
Conclusion
Lisinopril has demonstrated significant benefits in preserving kidney function across various conditions, particularly in reducing albuminuria and slowing the progression of renal insufficiency. While it is effective in both diabetic and non-diabetic nephropathies, its use in combination therapies requires careful consideration due to potential safety concerns. Overall, lisinopril remains a valuable agent in the management of chronic kidney diseases, offering both blood pressure control and direct renoprotective effects.
Sources and full results
Most relevant research papers on this topic
Long-Term Effect of Lisinopril and Atenolol on Kidney Function in Hypertensive NIDDM Subjects With Diabetic Nephropathy
Both lisinopril and atenolol effectively reduce kidney function decline in hypertensive NIDDM patients with diabetic nephropathy.
RCT
Highly CitedImpact of Lisinopril and Atenolol on Kidney Function in Hypertensive NIDDM Subjects With Diabetic Nephropathy
Lisinopril effectively reduces albuminuria more than atenolol in hypertensive NIDDM patients with diabetic nephropathy, potentially improving kidney function.
RCTHighly CitedSustained improvement of renal graft function for two years in hypertensive renal transplant recipients treated with nifedipine as compared to lisinopril.
Nifedipine improves kidney transplant function more effectively than lisinopril over a 2-year period in hypertensive renal transplant patients treated with cyclosporin.
RCTHighly CitedLong-term renoprotective effect of nisoldipine and lisinopril in type 1 diabetic patients with diabetic nephropathy.
Both lisinopril and nisoldipine have similar long-term renoprotective effects in hypertensive type 1 diabetic patients with diabetic nephropathy.
RCTHighly CitedCombined angiotensin inhibition for the treatment of diabetic nephropathy.
Combination therapy with an ACE inhibitor and an ARB is associated with an increased risk of adverse events in patients with diabetic nephropathy.
RCT
Large Human TrialHighly CitedEffect of Lisinopril on the progression of renal insufficiency in mild proteinuric non-diabetic nephropathies.
Lisinopril has a specific renoprotective effect in addition to blood pressure control in patients with mild proteinuria, slowing the progression of non-diabetic chronic renal diseases.
RCTRandomized Controlled Trial: Lisinopril Reduces Proteinuria, Ammonia, and Renal Polypeptide Tubular Catabolism in Patients With Chronic Allograft Nephropathy
Lisinopril therapy for 1 year effectively reduces proteinuria, renal proximal tubular polypeptide catabolism, and ammonia excretion in chronic allograft nephropathy patients without negatively impacting graft function.
RCT
Rigorous JournalThe effect of swimming exercise on adenine-induced kidney disease in rats, and the influence of curcumin or lisinopril thereon
Moderate swimming exercise, curcumin, or lisinopril alone can significantly improve kidney disease symptoms, but combining them with exercise may provide additional nephroprotection.
RCT
Animal StudyRigorous JournalChronic treatment with lisinopril decreases proliferative and apoptotic pathways in autosomal recessive polycystic kidney disease
Chronic lisinopril treatment can reduce renal cyst development in autosomal recessive polycystic kidney disease by altering proliferative and apoptotic pathways.
Non-RCTAnimal Study