血清胱抑素C评价肾小球滤过率的临床意义

目的探讨应用血清胱抑素C(CysC)判断肾小球滤率的价值。方法对235例患者分别用乳胶增强免疫透射比浊法测定血清CysC的浓度及使用苦味酸速率法和酶学传导速率法测定血清肌酐(Scr)、尿素氮(BUN),以99Tcm-DTPA清除率测得的GFR作为评价的标准,分析CysC、Scr、BUN和GFR之间的相关性;按照GFR值将患者分4组:A组GFR≥90 ml(/min.1.73 m2),B组60~89 ml/(min.1.73 m2),C组30~59 ml(/min.1.73 m2),D组<30 ml(/min.1.73 m2),依据单侧肾小球滤过率GFR<40 ml/min(60岁以上<35 ml/min)为肾滤过功能减退依据,比较CysC、Scr、BUN 3指标诊断各组分肾GFR下降敏感度与特异度。结果 235例患者,随着GFR下降,血清CysC、BUN、Scr均逐渐升高(P<0.01),血清CysC与GFR之间呈负相关(r=-0.649,P<0.01),血清CysC与Scr、BUN之间呈正相关(r=0.850、r=0.874,P<0.01)。A、B、C组患者血清CysC诊断分肾滤过功能下降敏感度分别为58.82%、76.56%和95.51%,均优于Sc(rP<0.01)、BUN(P<0.05);A、B组患者血清CysC诊断分肾滤过功能下降特异度低于Scr、BUN(P<0.05)。结论测定血清胱抑素C的浓度用来评价肾小球滤过功能是一种可行、敏感的指标,测定方法简便,对预测早期肾损害迅速灵敏,值得临床推广应用。     

肝素治疗对严重脓毒症患者肺、肾功能的影响

目的 探讨肝素对脓毒症患者肺、肾功能损害的治疗作用.方法 选择我院严重脓毒症患者67例,随机分成两组,对照组给予常规治疗,观察组在常规治疗的基础上加用肝素抗凝.比较两组患者入院后0h、6h、12 h、24 h、48 h氧合指数(OI)与血清肌酐清除率(Scr),以及住ICU天数.结果 对照组0h、6h、12 h、24 h、48 h OI分别为(105.4±32.0) mm Hg、(115.8±30.1) mm Hg、(131.2±29.1) mm Hg、(153.5±29.9) mm Hg、(186.6±37.6) mmHg,观察组0h、6h、12h、24 h、48 h OI分别为(103.6±28.3) mm Hg、(123.6±35.2) mm Hg、(147.3±31.7) mmHg、(174.7±41.4) mmHg、(212.2±37.3) mm Hg;对照组0h、6h、12 h、24 h、48 h Scr分别为(31.9:8.8) mL/min、(42.6±9.9) mL/min、(47.0±11.0)mL/min、(49.5±9.9) mL/min、(51.9±7.5)mL/min,观察组0h、6h、12h、24 h、48 h Scr分别为(30.9±10.3) mL/min、(46.4±13.0) mL/min、(58.2±12.1) mL/min、(63.3±13.1) mL/min、(65.1±10.5) mL/min;两组住ICU天数分别为7.2±2.0、5.8:1.2.观察组患者12 h、24 h、48 h氧合指数和血肌酐清除率明显高于对照组(P＜0.05);住ICU时间短于对照组(P＜0.05).结论 肝素可以改善严重脓毒症患者肺氧合指数,改善肾功能,降低住ICU时间.     

血清胱蛋白酶抑制剂C评估原发性高血压病肾功能检测

目的评价血清胱蛋白酶抑制剂C在原发性高血压病肾功能检测中的意义。方法选择原发性高血压病患者61例为高血压组,选择正常体检人员40例为对照组,测定血清胱蛋白酶抑制剂C、血肌酐、血尿酸浓度尿微量蛋白定量。结果原发性高血压肾小球滤过率>80mL/(min?1.73m2)的患者,其中UAER异常者,其血尿酸高于健康者(P<0.05)50相似文献   

血清胱抑素C测定的临床意义探讨

目的 检测血清胱抑素C(Cys-C)水平并探讨其反映肾小球滤过率(GFR)的临床意义。方法 应用酶联免疫吸附法测定62例肾病患者血清Cys-C水平。结果 血清Cys-C水平与血肌酐(SCr)星高度相关性(r=0.85),血清Cys-C、SCr浓度均与GFR呈反比,即[Cys-C]~(-1)与GFR相关性r=0.71,[Scr]~(-1)与GFR相关性r=0.68,单项测定血清Cys-C、SCr诊断异常GFR的灵敏度分别为83％、75％。结论 血清Cys-C浓度与GFR密切相关,可作为评价肾小球滤过率的指标,在评价肾功能时作用优于SCr。     

血清胱抑素C对慢性肾脏病患者早期肾功能损害的诊断意义

目的分析血清胱抑素C(Cys-C)对慢性肾脏病患者肾功能损害的诊断价值。方法回顾性分析2016年5月至2019年5月间来院治疗的310例慢性肾脏病患者,根据不同程度的肾功能损伤分为三组:A组(慢性肾脏病1、2期)、B组(慢性肾脏病3a期)和C组(慢性肾脏病3b期),分别为104例,103例和103例。三组患者均行Cys-C和肾功能指标检测。对比三组患者Cys-C、Scr、血尿酸(BUA)、血尿素氮(BUN)、Ccr等指标,并对比三组患者的Cys-C异常与Scr异常检出率。结果 B组与C组的Cys-C和肾功能指标均高于A组,且C组高于B组,差异对比具有统计学意义(P <0.05),Ccr为A组> B组> C组(P <0.05);慢性肾脏病1、2、3a期患者的Cys-C异常检出率明显高于Scr异常检出率,差异显著(P <0.05),而3b期患者Cys-C与Scr均异常,差异对比无显著(P> 0.05)。结论检测血清胱抑素C可对患者早期肾功能损伤进行诊断,从而为临床早期诊断和干预提供依据与参考,对于避免进展到肾脏病晚期具有重要临床意义。     

利福平注射液在结核病患者体内的药代动力学研究

测定利福平注射液的药代动力学。12例结核病患者静脉滴注300mg或600mg利福平注射液后,甲荧光偏振免疫法测定血药浓度。静脉给予利福平的平均血药峰浓度分别为(9.0±3.0)μg/mL和(17.5±5.0)μg/mL,机体清除率分别为(0.19±0.6)L/(kg h)和(0.14±0.03)L/(kg h),稳态分布容积为(0.66±0.14)L/kg和(0.64±0.1)L/kg。     

血清胱抑素C在老年原发性高血压患者肾功能损害诊断中的应用价值

目的探讨血清胱抑素C(Cys C)在老年原发性高血压(EH)患者肾功能损害诊断中的应用价值。方法将90例老年原发性高血压患者按尿白蛋白排泄率(UAER)分为正常蛋白尿组30例(UAER<20μg/min),微量蛋白尿组(UAER20~199μg/min)30例和大量蛋白尿组(UAER≥200μg/min)30例。测定各组Cys-C、血清肌酐(Scr)、肾小球滤过率(GFR)和UAER。结果随着UAER的增加,Cys-C、Scr和BUN明显增加,GFR逐渐下降;Cys-c与BUN、Scr和UAER呈正相关,与GFR呈负相关,但以Cys-C与GFR相关性最强(r=-0.72,P<0.05)。结论 Cys-C与老年原发性高血压患者肾功能损伤有明显的相关性,在老年原发性高血压肾功能损害,尤其是在早期肾功能损害的诊断中具有很好的诊断价值。     

胱抑素C在脓毒症相关的急性肾损伤中的诊断价值

目的胱抑素C(Cys-C)对脓毒症合并急性损伤(AKI)患者的诊断价值。方法选取2016年11月～2017年11月我院接收的100例脓毒症合并急性肾损伤患者作为观察组,同时选择同期在我院就诊的脓毒症患者100例作为对照组,均患者于入院2、24及48h时采集患者3mL静脉血检测Cys-C水平及血肌酐(Scr)水平,并计算肾小球滤过率(GFR),采用Pearson相关系数进行组间的相关性描述,采用ROC的灵敏性特异性对指标诊断价值进行判定。结果观察组患者入科24、48h时Scr水平明显高于对照组,而入院2h比较无明显差异,而Cys-C在上,两组患者入院2、24及48h比较差异均有统计学意义(P 0.05);CysC1-3与Scr1无相关性,Cys-C与Scr2-3呈正相关(均P 0.05);血清Scr、Cys-C与GFR均呈负相关(P0.05),而Cys-C与GFR的相关系数较Scr与GFR的相关系数更高;观察组患者Scr1的ROC曲线下面积为0.5,其余时间点的Scr及Cys-C的ROC曲线下面积均在0.8以上。观察组入科2h Cys-C的AUC约为0.815,Cys-C的临界值为1.15mg/L,Scr的AUC值约为0.546,临界值为110μmol/L。结论脓毒症相关的急性肾损伤患者血Cys-C水平明显升高,较Scr可更早反映肾脏损伤,对于急性肾脏损伤的早期识别有重要意义。     

几种肾小球滤过功能计算方法探讨

目的　探讨以血清肌酐为主要变量的公式法推算内生肌酐清除率的可靠性和适用范围。方法　比较 4 0例健康成人和 10 8例肾功能损害程度不一的肾小球疾病患者 ,99m Tc- DTPA肾动态显象所测肾小球滤过率(GFR)与实测内生肌酐清除率、不同公式估算的内生肌酐清除率值间的相关程度。结果　相关分析结果示仅在GFR为 30～ 6 0 ml- 1 · min- 1 · 1.73m- 2 时 99m Tc- DTPA肾动态显象测得 GFR与实测和公式法求得内生肌酐清除率值密切相关 (r≥ 0 .5 ,P<0 .0 1)。结论　公式法估算的 Ccr值仅适用于肾功能轻中度受损的患者     

血清半胱氨酸蛋白酶抑制剂对糖尿病肾损害的临床应用评价

目的探讨血清半胱氨酸蛋白酶抑制剂(CysC)对糖尿病肾损害的临床应用。方法用胶乳增强的速率散射比浊法测定CysC。用酶法测定血清和尿肌酐,并计算内生肌酐清除率(Ccr)值。结果Ccr在40～80ml/(min×1.73m2)时,CysC和Scr的值与正常对照组比较只有CysC有显著差异(P<0.01);Ccr<40ml/(min×1.73m2)时,其CysC和Scr的值与正常对照组比较均有显著差异(P<0.01)。结论血清CysC可以有效的反映糖尿病患者肾损害的程度。     

Predicting the glomerular filtration rate from serum creatinine, serum cystatin C and the Cockcroft and Gault formula with regard to drug dosage adjustment

OBJECTIVES: To compare the accuracy of the classification of the degree of decrease in glomerular filtration rate (GFR), measured exactly (as inulin clearance) on the basis of serum concentrations of creatinine (Scr), cystatin C (Scyst) and creatinine clearance predicted according to Cockcroft and Gault (CG), and to establish whether any of the above methods is more accurate than the other 2. SUBJECTS: The study was conducted in 126 patients (52 men, 74 women) aged 18 to 64 years with various chronic renal diseases (predominantly various forms of glomerulonephritis and tubulointerstitial nephritis). The study subjects were divided into 3 subgroups according to GFR levels. Subgroup A (n = 41) included individuals with GFR >50 ml/min/1.73 m2, subgroup B (n = 56) was made up by individuals with GFR of 20-50 ml/min/1.73 m2, while subgroup C (n = 29) comprised individuals with GFR <20 ml/min/1.73 m2. METHODS: GFR was determined on the basis of renal inulin clearance (Cin) under conditions of stable plasma levels and water loading. Each individual had his/her Scr, Scyst values measured and CG was calculated. Results were evaluated using discrimination analysis. RESULTS: Mean values and SD of the monitored markers in the subgroups were as follows. Subgroup A: Scr 102.4 (38.3) micromol/l, Scyst 1.46 (0.42) mg/l, CG 80.0 (19.2) ml/min/1.73 m2. Subgroup B: Scr 161.2 (45.6) micromol/l, Scyst 2.01 (0.55) mg/l, CG 46.1 (16.7) ml/min/1.73 m2. Subgroup C: Scr 314.9 (58.3) micromol/l, Scyst 3.41 (0.96) mg/l, CG 24.8 (7.6) ml/min/1.73 m2. The percent of correct classifications and the respective confidence intervals (95%) for the methods used were as follows. Subgroup A: Scr 79.3 (64.6, 94.0), Scyst 75.9 (60.3, 91.5), CG 86.2 (73.6, 98.8). Subgroup B: Scr 51.8 (35.5, 68.1), Scyst 57.1 (41.5, 72.7), CG 64.3 (48.6, 80.0). Subgroup C: Scr 90.2 (81.0, 99.2), Scyst 80.5 (68.1, 92.9), CG 87.8 (77.8, 97.8). The percent of correct classifications established on the basis of Scr, Scyst and CG in subgroup B is significantly lower than that of correct classifications in subgroups A and C (p < 0.05-0.001). The percent of correct classifications using Scr, Scyst and CG, estimated separately for each subgroup (A, B, C) does not differ significantly. CONCLUSIONS: The findings support the assumption that estimation of the decrease in GFR using Scr, Scyst and CG is, as regards their utilization in everyday practice, suitable for individuals with severely decreased GFR (<20 ml/min/1.73 m2) and for individuals with a decrease in GFR to levels >50 ml/min/173 m2. Estimation of the decrease in GFR using the above subgroups did not demonstrate significant differences among Scr, Scyst and CG. Using the above markers, estimation of the decrease in GFR is the least reliable with GFR values in the range of 20-50 ml/min/1.73 m2.     

Serum cystatin C for the prediction of glomerular filtration rate with regard to the dose adjustment of amikacin, gentamicin, tobramycin, and vancomycin

Dosage regimes of aminoglycosides and vancomycin are modified according to the glomerular filtration rate (GFR). In 130 hospitalized patients who were administered amikacin, gentamicin, tobramycin, and vancomycin by intermittent intravenous infusion, we compared the predicted GFR values from the serum concentrations of creatinine (Cockcroft and Gault. Nephron. 1976;16:31-41) and cystatin C (Larsson et al. Scand J Clin Lab Invest. 2004;64:25-30) with respect to their relevance for proper dosage. In 83% and 67% of the cases, respectively, the serum levels of albumin and cholinesterase were below the corresponding lower limit of the reference range. The ratio of creatinine/cystatin C concentrations presented significant correlations with the predicted rate of creatinine production (r=0.762, P<0.001), serum albumin concentration (r=0.205, P<0.05), and catalytic serum concentrations of cholinesterase (r=0.207, P<0.05), gamma glutamyltransferase (r=-0.273, P<0.01), and alkaline phosphatase (r=-0.289, P<0.01). The GFR (mean+/-SD; median) predicted by the serum creatinine (84.0+/-35.1 mL/min/1.73 m; 82.6 mL/min/1.73 m) was significantly higher (P<0.001) than that predicted by the serum cystatin C (53.1+/-30.2 mL/min/1.73 m; 44.9 mL/min/1.73 m). The ratio between the GFR values predicted by creatinine and cystatin C had a highly significant negative correlation with the rate of creatinine production (r=-0.912, P<0.001). Furthermore, significant differences were found for the peak concentrations and clearances of amikacin and vancomycin estimated by means of the Abbottbase Pharmacokinetic Systems program, and using the GFR values predicted by the serum creatinine and cystatin C (P<0.005). In patients with hepatic dysfunction, the clearance of creatinine predicted by the Cockcroft-Gault formula leads to a significant overestimation of the GFR. Cystatin C seems to be a valid alternative as a GFR marker with regard to drug dose adjustment in these cases.     

多种不同指标评估肾小球滤过率价值比较

目的比较胱抑素C（CysC）、血清肌酐（Scr）和内生肌酐清除率（Ccr）作为肾小球滤过率评估标志的价值。方法选取2012年1-8月在第三军医大学大坪医院健康体检人群和肾内科住院肾病患者共146例,其中健康对照组40例,肾病组106例。采用Beckman DXC-800全自动生化分析仪检测两组受检者CysC、Scr和Ccr。根据Ccr由高到低将肾病患者组分为四组[Ⅰ组（Ccr≥80 mL/min）36例,Ⅱ组（Ccr 50-〈80 mL/min）20例,Ⅲ组（Ccr 20-〈50 mL/min）30例,Ⅳ组（Ccr〈20 mL/min）20例],比较各组间各指标检测肾功能损害的敏感性及准确性。将Ⅰ组及健康对照组患者分为不同年龄组及不同性别组,分析各组间的Scr和CysC有无差异。结果 CysC随着Ccr降低而升高,二者呈负相关（r=-0.973,P=0.000）,Ccr在50-〈80 mL/min时,CysC已显著升高,而Scr仍在正常值范围内,说明CysC敏感性较Scr高;Ⅰ组及健康对照组不同年龄组间患者中Scr与CysC比较,差异无统计学意义（P〉0.05）,不同性别间CysC比较,差异无统计学意义（P〉0.05）,而Scr则男性高于女性,差异有统计学意义（P〈0.01）。Scr随着Ccr降低升高不明显,且其与Ccr的相关性较CysC与Ccr的相关性低。结论 CysC检测肾功能异常的准确性较高,较Scr更加敏感,且与Ccr呈负相关。检测CysC较Ccr更好,不受年龄、性别的影响。     

比较血清胱抑素C及肌酐对肝肾综合征的诊断价值

目的比较血清胱抑素C（CystatinC,cys-C）和血肌酐（Scr）在肝硬化失代偿期肾损伤及疾病预后等方面的诊断效能。方法选择肝硬化失代偿期患者82例,测定CysC、Scr及肌酐清除率（Ccr）,设定临界Ccr值,比较不同Ccr水平Scr及Cys-C的差别,通过ROC曲线分析比较两项指标的诊断效能。随访12个月,比较不同初始Ccr值患者病死率以及不同结局的患者初始CysC、Scr值。结果①以Ccr〈60mL／min为临界值进行分组,A组（Ccr≥60mL／min）40例,B组（Ccr〈60mL／min）42例,两组初始血肌酐值差异不显著,Cys-C值B组显著高于A组,ROC曲线分析提示Cys-CAUC值显著大于Scr;②随访病例74例,全因死亡18例,B组病死率显著高于A组。死亡患者初始Scr及Cys-C均显著高于对照组。结论CysC能更准确的反映肝硬化患者肾小球滤过功能,并且与患者预后有更高相关性,对肝硬化早期肾损害有较高诊断价值。     

肝肾综合征患者血清胱抑素C检测的临床评价

目的探讨血清胱抑素C(CysC)检测在肝肾综合征(HRS)诊断中的价值。方法以24小时肌酐清除率(24h-Ccr)作为肾小球滤过率(GFR)评估标准,将72例晚期肝硬化患者分为HRS组和非HRS组,同时设40例健康人作为正常对照组。所有待测者均测定血清CysC、血肌酐(Scr)、尿肌酐(Ucr)和血尿素氮(BUN)。比较分析各组间24-Ccr、CysC、Scr与BUN的水平差异、CysC、Scr、BUN与24-Ccr的相关性及其诊断的准确性。结果 CysC水平在HRS组与非HRS组间有非常显著性差异(P<0.01),而Scr与BUN在HRS与非HRS组间无显著性差异;CysC与24-Ccr的相关性最好,诊断灵敏度和特异度均优于Scr和BUN。结论 CysC能灵敏反映肝硬化患者肾功能早期损害,是评估HRS患者GFR较理想的指标。     

肾移植患者环孢素A血药浓度与胱抑素C的相关性分析

目的:研究肾移植患者术后不同时期的环孢素A(CsA)血药浓度与血清胱抑素C(CysC)和血清肌酐(Scr)的相关性。方法:118例肾移植患者术后肾功能稳定(肌酐清除率>40 ml/min),其中男性60例,女性58例,共监测307例次。术后同时监测CsA血药浓度、CysC值和Scr。结果:随着术后时间的延长,CsA血药浓度呈逐渐下降趋势,CysC的均值高于正常参考范围,而Scr值均在正常参考范围内。术后不同时间段组、不同药物浓度组的CsA血药浓度与CysC和Scr均无显著相关性。结论:肾移植术后CsA血药浓度的高低,不影响CysC、Scr对移植肾功能的评价。     

血清胱抑素C的检测对早期肾功能损害价值的探讨

目的 探讨血清胱抑素C（Cys-C）的检测在诊断早期肾功能损害中的应用价值.方法 将253例肾损害疾病患者根据肌酐清除率（Ccr）测量值大小分为肾功能正常组（A组）、肾功能轻度损害组（B组）、肾功能中度损害组（C组）、重度损害及尿毒症组（D组）4组,选取60名作为健康对照组,用颗粒增强散射免疫法检测血清Cys-C的浓度,同时用酶法检测血肌酐（Scr）、血尿素氮（BUN）、肌酐清除率（Ccr）,并对各组血清Cys-C、Scr和BUN进行分析比较.结果 肾病患者中肾功能正常组（A组）和肾功能轻度损害组（B组）仅Cys-C与健康对照组差异有高度统计学意义（P〈0.01）,而在肾功能中度损害组（C组）、重度损害及尿毒症组（D组）的Cys-C、Scr和BUN均与健康对照组差异有统计学意义（P〈0.01或P〈0.05）.结论 血清Cys-C是肾功能早期损害的灵敏诊断指标,可早期判断肾小球滤过功能损害.     

Serum cystatin C as an endogenous marker of renal function in the elderly

The glomerular filtration rate (GFR) is the main indicator of kidney function. In clinical practice the GFR is often estimated from serum creatinine. In the elderly, serum creatinine is notoriously unreliable as an estimator of GFR. Recently, serum cystatin C has been proposed as a new endogenous marker of glomerular filtration rate. A total of 144 patients, aged more than 60 years (mean age 70.4 years), who had undergone 51CrEDTA clearance, were enrolled in our study. In each patient serum creatinine and serum cystatin C were determined. The reciprocal of serum creatinine, the reciprocal of serum cystatin C and creatinine clearance (from Cockcroft and Gault formula) were calculated. Serum cystatin C was measured with the particle-enhanced immunonephelometric method. The mean 51CrEDTA clearance was 34.5+/-25.55 ml/min/1.73 m2, the mean serum creatinine was 312+/-210 micromol/l and the mean serum cystatin C 3.15 mg/l+/-1.62 mg/l. We found a significant correlation between 51CrEDTA clearance and serum creatinine, serum cystatin C, the reciprocal of serum creatinine and the reciprocal of serum cystatin C as well as with creatinine clearance. In comparison of the correlation coefficients we found that the correlation between 51CrEDTA clearance and serum cystatin C was significantly better than that with serum creatinine (p < 0.05). The correlation between 51CrEDTA clearance and the reciprocal of serum cystatin C was superior to that with the reciprocal of serum creatinine (p < 0.003) and calculated creatinine clearance (p < 0.003). Our results indicate that serum cystatin C is a more reliable marker of GFR in the elderly than serum creatinine or creatinine clearance.     

计算法与应用99mTc-DTPA清除率测定肾小球滤过率的临床对比研究

目的 评价临床应用计算法测定肾小球滤过率（GFR）的准确性。方法 用^99mTc-DTPA清除率测定60例不同疾病住院病人GFR（Tc-GFR)，并测血清肌酐，同时以WCP公司测定GFR（WCP-GFR),以Cockcroft/Gault公式计算内生肌酐清除率（CG－CCr)。肾功能不全及正常组WCP－GFR、CG－GFR分别与Tc-GFR进行相关分析，比较两组WCP－GFR、CG－GFR与Tc-GFR间显著性差异以及WCP－GFR、Tc-GFR间平均差和CG－GFR、Tc-GFR间平均差的显著性差异。结果 WCP－GFR及CG－CCr均可在一定程度上准确反映GFR，而以WCP－GFR数值更接近Tc-GFR，准确性更高，临床上可代替Tc-GFR。结论 WCP－GFR是一种准确、简便、快捷测定GFR方法。     

Effect of benazepril monotherapy in subjects with hypertension associated with renal dysfunction

Nine hypertensive patients with mild to moderate renal dysfunction were entered into a protocol to assess the blood pressure, humoral and renal effects of the angiotensin converting enzyme inhibitor, Benazepril (CGS14824A, 2 to 20 mg twice daily) in patients with hypertension and moderate renal insufficiency (mean creatinine clearance 56 ml/min/1.73 m2). Specifically monitored, prior to and following 12 weeks of Benazepril monotherapy, were plasma renin activity and plasma aldosterone, the clearances of creatinine, Tc99m-diethylenetriaminepentaacetic acid (TC99m-DTPA) and para-amino-hippurate, and the 24-hour urinary excretion of protein. Blood pressure was well controlled. Plasma renin activity was stimulated, and plasma aldosterone was suppressed. Mean serum potassium increased from 3.9 to 4.2 mEq/L. Benazepril monotherapy had no adverse renal hemodynamic effect. Benazepril appears to be an effective antihypertensive agent in hypertensive patients with moderately impaired renal function.