Effect of Captopril on Diabetic Proteinuria

To the Editor: The report by Taguma et al. (Dec. 26 issue), that administration of the angiotensin-converting-enzyme inhibitor captopril resulted in a decline in urinary protein excretion in diabetic patients with nephropathy, must be interpreted with caution. The 10 patients described generally had advanced renal impairment (mean serum creatinine level, 5 mg per deciliter). Five of the 10 had congestive heart failure — 1 had vomiting, and all were taking powerful diuretic agents — all conditions likely to have stimulated the renin–angiotensin–aldosterone system. It is a pity, then, that no information was provided on the circulating levels of these hormones, . . . No extract is available for articles shorter than 400 words.