The effect of captopril on severe renin-dependent hypertension of uraemics on regular dialysis treatment.

The renin-dependent hypertension of uraemic patients on regular dialysis treatment (RDT), resistant to conventional therapy, is a major problem. In these cases, bilateral nephrectomy is effective but carries operative risks and also the possibility of worsening the patients' anaemia. Five uraemic patients on RDT, with severe renin-dependent hypertension resistant to medical therapy were treated with the oral angiotensin converting enzyme inhibitor captopril for 3 to 6 months and the effects of the drug were studied. The pretreatment blood pressure was lowered from 227 +/- 5.7/127 +/- 4.47 mmHg to 146 +/- 13.42/86 +/- 4.18 mmHg within a month of treatment with captopril and that result was maintained throughout the study. A transient loss of taste was seen in two cases, but no other serious side effects of the drug were observed. In conclusion, captopril is a very effective drug in treating the severe renin-dependent hypertensive uraemic patients on RDT.