Renal Alteration Clinical Trial
Official title:
A Randomized, Double-blind, Placebo-controlled Clinical Trial to Evaluate the Efficacy and Safety of Benazepril (ATC N° C09AA07) in the Treatment of Persistent Renal Dysfunction in Pre-eclamptic Women
The purpose of the Post-preeclampsia Renal Project is to investigate the renal function of preeclamptic women after delivery, and to determine whether the anti-hypertensive drug named benazepril efficiently improves the dysfunctions observed.
Several epidemiological studies suggest that the risk of death from cardiovascular causes
among women with preeclampsia may be increased, and that preeclampsia contrary to what has
been long thought, is not cured with delivery. Preeclampsia has long been considered a
2-stage disease, stage one corresponding to an impaired placental perfusion resulting from
abnormal spiral artery remodeling, and stage two corresponding to the maternal manifestations
of disease, characterized by hypertension and proteinuria. However, preeclampsia might
include an additional, 3rd stage, that of the post-partum period (Gammill & Roberts, 2007)
This phase deserves to be investigated. In particular, it is crucial to determine whether the
changes that occur in renal hemodynamics during preeclampsia are reversible after more than 6
weeks, and whether PEC women are salt-sensitive after delivery.
The link between chronic kidney disease and cardiovascular mortality is well established. An
independent, graded association exists between a reduced GFR and the risk of death,
cardiovascular events, and hospitalization (Go et al, 2004). Besides, salt-sensitivity is
associated with an increased cardiovascular and renal risk (Franco & Oparil, 2006). The Renal
Post PEC study aims at establishing if the renal dysfunctions that occur in PEC women can be
reversed by the administration of inhibitors of the renin-angiotensin system that are known
to improve cardiovascular and renal risk profiles in hypertensive patients. By virtue of
their potent renal vasodilatory properties and favourable remodelling of the GBM, ACE
inhibitors may improve salt-sensitivity, endothelial function, renal plasma flow and GFR, and
general renal prognosis in women who experienced from preeclampsia.
;