Pediatric Nephrology

, Volume 19, Issue 3, pp 271–275

Enalapril in children with Alport syndrome

Original Article

DOI: 10.1007/s00467-003-1366-z

Cite this article as:
Proesmans, W. & Van Dyck, M. Pediatr Nephrol (2004) 19: 271. doi:10.1007/s00467-003-1366-z
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Abstract

Ten pediatric patients with Alport syndrome received enalapril for 5 years. There were nine boys. Eight patients have the X-linked form of the disease and two the autosomal recessive form. The median age at the start of treatment was 10.25 years. Only one patient was hypertensive. The starting dose of enalapril was 0.05 mg/kg; the target dose was 0.5 mg/kg per day. The median dose given effectively was 0.24, 0.37, 0.45, 0.43, and 0.49 mg/kg per day at years of study 1, 2, 3, 4, and 5, respectively. The median urinary protein/creatinine ratio was 1.58 g/g (range 0.49–4.60) before treatment. This decreased to 0.98, 1.09, 1.35, 1.11, and 1.38 g/g after 1, 2, 3, 4, and 5 years, respectively. The median creatinine clearance at baseline was 100 ml/min per 1.73 m2 (range 82–133) and after 5 years 92 ml/min per 1.73 m2 (range 22–115). Three patients did not reach the target dose of enalapril because of orthostatic hypotension. One of them was the only patient to develop chronic renal failure within 5 years. The present study indicates that enalapril reduces urinary protein excretion and preserves glomerular filtration in Alport patients as a group. However, there was individual variation, as in most studies of patients with proteinuric nephropathies given inhibitors of the angiotensin-converting enzyme.

Keywords

Alport syndrome Angiotensin-converting enzyme inhibitors Enalapril Renoprotection 

Copyright information

© IPNA 2004

Authors and Affiliations

  1. 1.Renal Unit, Department of PediatricsUniversity Hospital GasthuisbergBelgium

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