Effect of fosinopril in children with steroid-resistant idiopathic nephrotic syndrome.
We aimed to test if fosinopril reduces urinary protein excretion and alleviates renal tubular damage in normotensive children with steroid-resistant idiopathic nephrotic syndrome (SRINS). We also aimed to evaluate whether there are changes in steady-state blood pressure and serum concentrations of serum angiotensin-converting enzyme (ACE) and plasma renin activity or angiotensin II (AT-II) in children under this treatment. Forty-five normotensive patients with SRINS were randomly divided into two groups. Group I was treated with fosinopril and prednisone for 12 weeks, while group II was treated with prednisone alone for the same duration. The values of 24-h urinary protein excretion were 1.25+/-0.64 vs 2.52+/-0.56 g/24 h (P<0.05), 1.16+/-0.45 vs 2.42+/-0.24 g/24 h (P<0.05), and 1.10+/-0.41 vs 2.05+/-0.46 g/24 h (P<0.05) in group I and group II patients, respectively, at 4, 8, and 12 weeks. Patients in group I showed lower serum concentrations of urinary retinol-binding protein and beta(2)-microglobulin (P<0.01) at the end of the study, but the patients' blood pressure and components of the renin-angiotensin system (RAS) had no change during treatment. The result suggested that fosinopril significantly reduced proteinuria and alleviated renal tubular damage, but did not influence blood pressure and components of systemic RAS in normotensive children with SRINS.
Yi
Zhuwen
Z
Laboratory of Pediatric Nephrology, Institute of Pediatrics, The Second Xiangya Hospital, Central South University & Hunan Province Clinical Center of Pediatric Nephrology, Changsha, Hunan, 410011, People's Republic of China. csuxyyzw@hotmail.com
Li
Zhihui
Z
Wu
Xiao-Chuan
XC
He
Qing-Nan
QN
Dang
Xi-Qiang
XQ
He
Xiao-Jie
XJ
D000804:Angiotensin II / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D017328:Fosinopril / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000188:drug therapy*; D007703:Peptidyl-Dipeptidase A / Q000097:blood / Q000737:chemistry; D011239:Prednisolone / Q000627:therapeutic use; D011507:Proteinuria / Q000378:metabolism; D012083:Renin / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D005938:Glucocorticoids; D000804:Angiotensin II; D011239:Prednisolone; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A; D012083:Renin; D017328:Fosinopril