Captopril test in children with reflux nephropathy.
We studied the plasma renin activity (PRA) and blood pressure (BP) responses to a single oral dose of captopril in children with renal scarring due to vesicoureteral reflux. The test was performed on 19 children, of whom 13 were normotensive and 6 hypertensive. Basal PRA was within the normal range for age for all except 1 patient. Mean basal PRA values for normotensive and hypertensive patients were not significantly different. At 90 min post captopril, the mean PRA increase was 3.61 ng/l per second (SD = 7.07) in the normotensive group but only 0.77 ng/l per second (SD = 0.83) in the hypertensive group. In 11 patients the average systolic BP 60-90 min post captopril was 0.9%-12.4% lower than the basal value. Diastolic BP decreased after captopril administration in 10 patients and increased in 9. The changes in mean arterial pressure and PRA between 0 and 90 min post captopril were inversely correlated (r = 0.605, P less than 0.01). Because of the PRA responsiveness in the normotensive patients with renal scarring, we suggest that there was activation of the renin-angiotensin axis in this group. However, it is not apparent whether such patients are more at risk of developing hypertension at a later time.
Hamed
R M
RM
Division of Nephrology, Hospital for Sick Children, Toronto, Ontario, Canada.
Ellis
G
G
Levy
M
M
McLorie
G A
GA
Balfe
J W
JW
D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects; D014718:Vesico-Ureteral Reflux / Q000097:blood / Q000150:complications* / Q000503:physiopathology
D002216:Captopril; D003404:Creatinine; D012083:Renin