Benazepril – The evidence for use in kidney disease


Slow disease advancement and extend lifespan

(2006) Mizutani H, Koyama H, et al. Evaluation of Clinical Efficacy of benazepril in the treatment of chronic renal insufficiency in cats. This is a prospective, randomized, placebo-controlled clinical trial of 6 months duration.  “These results suggest a potential for benazepril to delay the progression of disease, extend survival time, or both in cats with chronic renal insufficiency.  A statistically significant benefit of benazepril on the veterinarian’s assessment of overall efficacy and a non-significant trend to improved quality of life with benazepril was observed.  These results suggest improved well-being or quality of life of the cats treated with benazepril.  Possible mechanisms of action for these effects are reduced systemic hypertension or improved appetite with benazepril.”


Safe and increased appetite

(2006) King JN, Gunn-Moore DA, et al. Tolerability and efficacy of benazepril in cats with chronic kidney disease found “Benazepril is well tolerated … and cats treated with benazepril had a better appetite than those treated with a placebo.”


Prolonging life and kidney function

(2009) Chew DJ & DiBartola SP Proceedings of the Southern European Veterinary Conference & Congreso Nacional states “Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril, benazepril) may have protective effects in patients with chronic renal disease due to their ability to block adverse effects of angiotensin II. ACE-inhibition reduces glomerular capillary hydraulic pressure by decreasing postglomerular arteriolar resistance. Proteinuria is decreased secondary to decreased glomerular hydraulic forces and development of glomerulosclerosis is limited when protein trafficking across the glomerulus is decreased. Remnant nephrons in animals with CRF have glomerular hypertension that can benefit from reductions in transglomerular forces. An additional potential benefit from ACE-inhibition is improved control of systemic blood pressure. This beneficial effect must be balanced against their potential to worsen azotemia since glomerular pressure provides the driving force for GFR in the “super-nephron.”


Well tolerated in a heterogeneous population of cats

(2017) Lavallee JL, Norsworthy GD, et al. Safety of benazepril in 400 azotemic and 110 non-azotemic client owned cats (2001-2012)  “The long-term survival of cats that had >30% increases in creatinine from baseline was not statistically different from the survival of those that did not experience these increases, which suggests this finding may not be a reason to discontinue therapy.  Benazepril appeared to be safe in a heterogeneous population of cats.”

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