[Efficacy of Enalapril in patients with single kidney and with or without normoprotein diet].
BACKGROUND
The patient with a solitary kidney and free protein intake can present pathological microalbuminuria.


OBJECTIVE
To evaluate the efficacy of Enalapril in patients with single kidney and with or without normoprotein diet.


METHODS
We studied 49 patients, mean age 11 years, eutrophics, with normal renal function and with approved medical consent. The exclusion criteria were: uropathies, arterial hypertension, malignant diseases, orthostatic proteinuria and previous treatments with nephrotoxics drugs. Patients were classified in two groups: Group A: with normoprotein diet (0.8 to 1.2 g/kg/day). Group B: with free protein intake. The patients with abnormal microalbuminuria received Enalapril (doses between 0.1-0.3 mg/kg/ day).


RESULTS
Group A: 21 patients, 2 with abnormal microalbuminuria. Mean increase of the renal size 14% (SD 8), risk of presenting pathological microalbuminuria: 9%. Group B: 28 patients, 11 with pathological microalbuminuria. Mean increase of the renal size: 33.8% (SD 6.1), risk of presenting abnormal microalbuminuria: 40%. RR: 4.125 (CI 1-16) (p: 0.01). NND: 3. Mean range of microalbuminuria pre- Enalapril 50 microg/min and post-Enalapril 11 microg/ min. Mean doses of Enalapril: 0.2 mg/kg/day. Correlation coefficient between increase of renal size and microalbuminuria range: 0.75 and between increase renal size and protein intake: 0.72. Mean time to reach abnormal microalbuminuria: 81 months (DS 7).


CONCLUSIONS
Enalapril together with the normoprotein diet in patient with single kidney reduces the risk of developing abnormal microalbuminuria.
Liern
Miguel
M
Servicio de Nefrología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires. Jliern@yahoo.com
Maldonado
Laura
L
Jordán
Pablo
P
Vallejo
Graciela
G
D000293:Adolescent; D000419:Albuminuria / Q000188:drug therapy*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002648:Child; D004044:Dietary Proteins; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney; D008297:Male; D012189:Retrospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D004044:Dietary Proteins; D004656:Enalapril