Captopril in the treatment of scleroderma renal crisis

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Abstract
Scleroderma is a disease of unknown cause characterized by interstitial fibrosis and vascular lesions in many organ systems. Renal failure, often associated with malignant hypertension, may ensue as a life-threatening component of this disorder. Activation of the renin-angiotensin-aldosterone system has been hypothesized as a cause of this complication. Captopril was used in 23 patients with this condition. Of this group, 20 (87%) responded favorably with a decrease of the supine diastolic BP to less than 90 mm Hg and a reduction in the serum creatinine level in 14 patients. During long-term therapy (median, 29 mo.), 11 of the 23 patients continued to have a good clinical response while receiving captopril. Six patients died and 6 patients were alive after captopril therapy was discontinued. These data suggest that captopril is beneficial in the treatment of scleroderma renal crisis.

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