Lipid disorders resulting from chronic kidney diseases can be safely improved with the highest doses of angiotensin converting enzyme inhibitor therapy that patients can tolerate.
This approach can ameliorate hypertriglyceridaemia through a direct, dose-dependent effect, report researchers in Bergamo, Italy. It could also improve hypercholesterolaemia through the nephrotic syndrome, especially in patients with more severe hypoalbuminaemia.
The researchers assessed the extent to which up-titration of lisinopril to maximum tolerated daily doses of 10 to 40 mg. (median 30 mg.), given to in 28 patients with non-diabetic chronic kidney disorders, ameliorated proteinuria. They also assessed the effect of the dosing on the dyslipidaemia which often complicates chronic nephropathies and increases the risk of renal and cardiovascular events.
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