ACE inhibition in the treatment of children after renal transplantation.
Currently, there are no data available on long-term effects of angiotensin-converting enzyme inhibitors (ACE-I) on graft function in children after renal transplantation. We therefore analyzed all children who were transplanted at our institution between 1989 and 1998 and followed for at least 2 years. Those treated with ACE-I, mainly because of failure of other antihypertensive medications, were compared to those without ACE-I. The ACE-I-treated children ( n=19) showed significantly better blood pressure control during the 1st year of follow-up ( p<0.05). In children with chronic allograft dysfunction ( n=8), treatment with ACE-I stabilized graft function, with improvement in creatinine clearance in 50% ( p<0.01). Serum potassium and hemoglobin levels remained stable. One patient discontinued ACE-I because of renal artery stenosis. Taken together, ACE-I were effective and safe in the treatment of hypertension in children following renal transplantation. Children with chronic allograft dysfunction experienced a stabilizing effect on graft function.
Arbeiter
Klaus
K
Kinderdialyse, Department of Pediatrics, AKH Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Pichler
Andrea
A
Stemberger
Regina
R
Mueller
Thomas
T
Ruffingshofer
Dagmar
D
Vargha
Regina
R
Balzar
Egon
E
Aufricht
Christoph
C
D000293:Adolescent; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007674:Kidney Diseases / Q000188:drug therapy / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D011182:Postoperative Care; D011184:Postoperative Period; D012189:Retrospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D003404:Creatinine