Studies In Renal Disease

The individual response to treatment with ACE inhibitors is highly variable.[20] Therefore, several studies have been conducted in which the efficacy of ACE inhibitor therapy was studied in relation to ACE genotype in patients with kidney diseases (Table 2). Yoshida et al.[21] studied the response to ACE inhibitor therapy in 21 Japanese patients with IgA-nephropathy, who were treated with lisinopril (10 mg/day). After 4 years of therapy, only patients with DD genotype showed a significant reduction in proteinuria. These results were confirmed by Moriyama et al.[22] in patients with various renal diseases and by Ha et al.[23] in patients with diabetic nephropathy. Those results are also consistent with a study performed by Perna et al.[24] Proteinuria, change of glomerular filtration rate, and progression to end-stage renal disease were effectively reduced by treatment with ramipril in patients with the DD genotype. Interestingly, ethnic background may play a very important role as mentioned before, as three of the four studies showing a more efficient reduction in

Table 2 Studies in patients with various renal diseases evaluating the response to ACE inhibitor therapy in relation to ACE genotype

Reference

Study drug

Phenotype

Improved effect of ACE inhibitor therapy in DD individuals

[21] Lisinopril Proteinuria

[22] n.s. Proteinuria

[23] n.s. Proteinuria

[24] Ramipril Loss of GFR

Improved effect of ACE inhibitor therapy in II individuals

Improved effect of ACE inhibitor therapy in DD individuals

[21] Lisinopril Proteinuria

[22] n.s. Proteinuria

[23] n.s. Proteinuria

[24] Ramipril Loss of GFR

Improved effect of ACE inhibitor therapy in II individuals

[25]

Enalapril

Loss of GFR

[26]

Enalapril,

Proteinuria

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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