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The aim of this study was to evaluate the agreement between the glomerular filtration rate (GFR) and an estimate of creatinine clearance (CCr), calculated from the values of body cell mass (BCM) and of plasma creatinine (PCr), thus avoiding urine collection. The value of BCM was obtained from the measurement of total body impedance in 80 renal patients. The relationship between 24-hour urinary creatinine excretion and BCM was evaluated in 30 of these patients. Body cell mass CCr (ml/min) was then calculated in each of the remaining 50 patients. For comparison, 24-hour CCr was measured in the same patients. The correlation coefficient of BCM CCr with GFR was 0.961, while that of 24-hour CCr with GFR was 0.869. Also, the agreement with GFR was better for BCM CCr than for 24-hour CCr. In conclusion, creatinine clearance predicted from body cell mass and plasma creatinine is a better indicator of renal function than measured 24-hour creatinine clearance.

Tumor-associated trypsin inhibitor (TATI) is a low molecular weight protein employed as tumor marker. To evaluate the role of the kidney in the clearance of TATI we studied the relationship of serum TATI with the glomerular filtration rate (GFR), and for comparisons the relationships of beta 2-microglobulin (beta(2m)) and creatinine with GFR. Urine excretion and renal extraction of TATI were also determined. The decrease in GFR was accompanied by an increase in blood levels of TATI, beta(2m) and creatinine. Serum TATI increased 12.4 times in patients with renal failure (GFR < 20 ml/min) with respect to subjects with normal renal function (P < 0.001, non-parametric Mann-Whitney test), while beta(2m) increased 7.3 times (P < 0.001) and creatinine 4.7 times (P < 0.001). In patients with GFR 60 to 40 ml/min, only the increase in TATI was statistically significant (p < 0.005). Renal excretion of TATI was low but it increased progressively in renal failure. Renal extraction ranged from 13% to 41%, for a mean 24.87. These results suggest that TATI is handled by the kidney and that it is a snesitrive marker of reduction in renal function.

The effects of the treatment with benazepril (BEN) on blood pressure and renal function have been evaluated in nine adult patients affected by mild to moderate hypertension. BEN was administered orally, at a single daily dose of 10 mg for four weeks. BEN induced a clinically significant decrease in blood pressure, from a mean basal value of 155/98 mm Hg (+/- 15/7 SD) to 146/92 (+/- 12/9) after seven days of therapy and 139/88 (+/- 11/10) after 28 days in supine position and from 152/104 (+/- 17/6) to 144/97 (+/- 14/6) after seven days and 145/99 (+/- 16/9) after 28 days in a standing position. Plasma urea, creatinine, uric acid and their clearances as well as urine enzymes (GGT, ALP, LDH) remained stable throughout the duration of the therapy. GFR showed a modest increase, from 61.3 +/- 13.2 ml/min to 65.3 +/- 18.3 ERPF showed a slightly more evident increase, from 246.7 +/- 68.1 ml/min to 276.9 +/- 75.6. Plasma levels of glucose, cholesterol and triglycerides were not influenced by BEN. Plasma potassium increased from 4.0 +/- 0.3 to 4.4 +/- 0.5 mEq/liter. The results of this study indicate that BEN is a safe and effective antihypertensive agent that does not cause any adverse renal or metabolic effects.

The effects of diltiazem (DTZ) treatment on blood pressure, renal function and renal hemodynamics over a six week period of therapy were evaluated in 14 adult patients with mild to moderate hypertension. Their creatinine clearances were 64 to 153 ml/min. After a week of treatment with placebo, DTZ was administered orally at a daily dose of 120 mg b.i.d. Blood pressure decreased from a mean value of 152/99 mm Hg (+/-13/6 SD) up to 144/91 (+/-17/8, P < 0.005) in the supine position and from 149/107 (+/-14/9) to 141/96 (+/-16/9, P < 0.005) in standing position. Heart rate decreased from 74 (+/-9) to 69 (+/-8). Plasma urea, creatinine, uric acid and their clearances as well as GFR and ERPF remained stable throughout the trial. Plasma glucose increased from 81 (+/-15) mg/dl to 98 (+/-30, P < 0.05) and plasma potassium decreased from 4.0 mEq/liter to 3.7 (+/-0.3, P < 0.005). Plasma cholesterol and triglycerides were unmodified. DTZ is an effective antihypertensive agent which does not significantly affect renal function. The effects on plasma glucose and potassium require periodical check-ups of these parameters.