[Long-term effect of angiotensin-converting inhibitors in children with proteinuria].
BACKGROUND
Prolonged proteinuria is a risk factor for renal damage. Angiotensin-converting enzyme (ACE) inhibitors can reduce proteinuria in adults with different types of nephropathy.


METHODS
We evaluated treatment with low doses of ACE inhibitors (captopril and enalapril) in nine children with proteinuria due to chronic glomerular nephropathy. The patients' diagnoses were Henoch-Schönlein nephropathy, Berger's disease, Alport's disease, and chronic glomerulonephritis (GN) (membranous GN, focal and segmental GN, and membranoproliferative GN). None of the patients were receiving concomitant treatment. Those who had received corticoids, immunosuppressive or hypotensive drugs during the previous 3 months were excluded. The medication was administered over a prolonged period (mean 26.6 6.36 months).


RESULTS
Proteinuria was initially in the nephrotic range (M = 55.34 10.44 mg/m2/h). In all patients concentrations fell significantly after 6 months and at the end of the treatment(p = 0.01 and p = 0.05). No adverse reactions to the medication were observed. The decrease in glomerular filtration rate was not significant. No significant changes in arterial pressure were found during treatment.


CONCLUSIONS
ACE inhibitors could be an effective alternative for reducing proteinuria in children with prolonged nephropathy. These inhibitors do not produce the adverse effects associated with other drugs and can therefore be used for long periods.
Camacho Díaz
J A
JA
Sección Nefrología. Unidad Integrada Hospital Clínic-Hospital Sant Joan de Déu. Universidad de Barcelona. jcamacho@hsjdbcn.org
Giménez Llort
A
A
García García
L
L
Jiménez González
R
R
D000293:Adolescent; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011507:Proteinuria / Q000188:drug therapy*; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D002216:Captopril