الفهرس 
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Abstract
Angiotensin receptor blockade have been proven to mitigate the unpleasant inflammatory and histological changes after relief of obstructive uropathy in animal models. Nevertheless, these witnessed effects have not been yet translated into clinical implications. This study was conducted to assess whether losartan could facilitate the recoverability of renal function after addressing the reasons of obstructive uropathy. METHODS: A randomized controlled trial was conducted in a tertiary referral center for 100 patients admitted with obstructive uropathy owing to benign ureteral obstruction in a solitary kidney. After relief of obstruction, patients have been randomized to receive either losartan or control groups, which belongs to angiotensin receptor blocker group (ARBs) was given as a single daily dose starting from the day of study enrollment and for 3 months after endoscopic relieve of ureteral obstruction.) starting from the day of intervention. Serum creatinine (SCr) was recorded daily until dropping to nadir level and patient is discharged. Diuretic renography was conducted at time of discharge, and, similar to SCr, at 1 and 3 months post-operatively. A sample size of 40 patients in each group is required to prove the assumed difference between the two groups. RESUTLS: a total of 80 patients were randomized, including forty patients received Losartan whilst 40 patients in control group and have completed 3-month follow-up. Demographics and perioperative data were comparable in both groups. The median (range) serum creatinine at presentation was 2 mg/dl (0.9-6.8)mg/dl in Losartan group compared to 5.9(3-13) in control group (p=0.33). Concerning Losartan group, serum creatinine has drastically fallen to 2 (0.9-6.8) mg/dl (p<0.001) over a median of 2 (1-8) days. Likewise, it takes a median of 2 (1-9) days for the control group to have SCr significantly reduced to 2.27 mg/dl (0.8-7.2) mg/dl (p<0.45). The median (range) rate of decline of SCr was 1.1 mg/dl/day in Losartan group compared to 1.8 (0.3-4.7) in placebo group. from discharge to first follow-up at one month, both groups showed a further DROP of SCr but in equal proportions (p=0.06). from then on, SCr has levelled off at 3 months of follow-up. Similarly, the median (range) glomerular filtration rate, as estimated by diuretic renography, has shown a considerable rise of renal function with an equal slope in both groups over the 3-month period (p=0.34). Conclusions: Apparently, Losartan treatment does not contribute to renal function recoverability after relief of obstructive uropathy. Nonetheless, notably, values were always in favor of losartan group but differences did not reach the levels of statistical significance. The previous results is probably attributed to the fact that renal damage progresses despite of improvement of renal function after relief of unilateral ureteral obstruction.