TREATMENT OF PERSISTENT RENAL DYSFUNCTION AFTER PREECLAMPSIA WITH BENAZEPRIL: A RANDOMIZED, DOUBLE-BLIND TRIAL. (June 2022)

• Record Type: Journal Article
• Authors: Pechère-Bertschi, Antoinette; Dufey, Anne; Wuerzner, Gregoire; Jaques, David; Burnier, Michel; Tejada, Begonia Martinez De; Seigneux, Sophie De; Ponte, Belén
• Is Part Of: Journal of hypertension. Volume 40(2022)Supplement 1
• Page Start: e275
• Publication Date: 2022-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000838364.80514.c5
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Preeclampsia increases the long-term cardiovascular and renal risk of women. Guidelines recommend to closely follow pre-eclamptic women in the post-partum (PP), but there is no consensus about treatment in women with early persistent kidney damage and high blood pressure after delivery. Objectives: to assess the efficacy of benazepril in improving surrogate markers of renal function of the PP period. Design and method: This was a double blind randomized controlled trial (benazepril 10 mg or placebo) in women with persisting microalbuminuria and/or blood pressure > 140/90 mmHg, and/or ongoing antihypertensive treatment 6–8 weeks PP. The primary outcome was to assess the efficacy of benazepril on GFR, albuminuria, CRP and blood pressure at 3 and 6 months. Results: We included 120 preeclamptic women, mean age was 34.1 ± 5.4 y, BMI before pregnancy was 25.7 ± 5.4 kg/m2; 6 weeks after delivery mean GFR was 114.5 ± 17.6 ml/min/1.73m2, microalbuminuria/urine creatinine ratio was 9.4 ± 13.9 mg/mmol, CRP was 9.3 ± 14. mg/L, SBP was 130.6 ± 13.1, and DBP was 90.4 ± 11.4 mmHg. At 3 months (resp. 6 months) postpartum, microalbuminuria and blood pressure improved in both groups but both parameters were significantly lower with benazepril than with placebo group (Table). Conclusions: Our study shows that benazepril was effective to improve renal surrogates in women having suffered from preeclampsia. The clinical benefits of maintaining the treatment beyond 6 months remain to be demonstrated.