Abstract
The effect of enalapril on urinary protein excretion and renal function was studied in six paediatric patients with various renal diseases causing nephroticrange proteinuria. In three younger children (aged 7–9 years) with steroid-resistant nephrotic syndrome, enalapril at a dose of 0.5 mg/kg per day given for 24 months yielded a temporary reduction of proteinuria in one child, a moderate and steady decrease in another and a complete disappearance of proteinuria in the third. Three adolescents, aged 17 years, took enalapril for 24 months at a dose of 20 mg/day. We observed no effect on proteinuria in one patient with Alport syndrome, a complete disappearance or urinary protein in one patient with membranoproliferative glomerulonephritis and a moderate decrease in the third patient who had idiopathic steroid-resistant nephrotic syndrome. Enalapril therapy resulted in an important reduction of proteinuria in two patients and a moderate decrease in three others. However this therapy was accompanied by a fall in glomerular filtration in all subjects, which was very marked in two patients. This fall in glomerular filtration may, however, simply reflect the natural course of the disease.
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References
Anderson S, Brenner BM (1987) Therapeutic implications of converting-enzyme inhibitors in renal disease. Am J Kidney Dis 10: 81–87
Anderson S, Rennke H, Brenner BM (1986) Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat. J Clin Invest 77: 1993–2000
Terzi F, Beaufils H, Laouari D, Burtin M, Kleinknecht C (1992) Renal effect of antihypertensive drugs dependent on sodium diet in the excision remnant kidney model. Kidney Int 42: 354–363
Trachtman H, Del Pizzo R, Valderrama E, Gauthier B (1990) The renal functional and structural consequences of corticosteroid and angiotensin-converting enzyme inhibitor therapy in chronic puromycin aminonucleoside nephropathy. Pediatr Nephrol 4: 501–504
Brouhard BH, Takamori H, Satoh S, Inman S, Cressman M, Irwin K, Verkley V, Stowe N (1994) The combination of lovastatin and enalapril in a model of progressive renal disease. Pediatr Nephrol 8: 436–440
Heeg JE, De Jong PE, Van der Hem GK, De Zeeuw D (1987) Reduction of proteinuria by angiotensin converting enzyme inhibition. Kidney Int 32: 78–83
Praga M, Hernandez E, Montoyo C, Andres A, Ruilope L, Rodicio J (1992) Long-term beneficial effects of angiotensin-converting enzyme inhibition in patients with nephrotic proteinuria. Am J Kidney Dis 20: 240–248
Zuchelli P, Zuccala A, Borghi M, Fusaroli M, Sasdelli M, Stallone C, Sanna G, Gaggi R (1992) Long-term comparison between captopril and nifedipine in the progression of renal insufficiency. Kidney Int 42: 452–458
Gansevoort RT, De Zeeuw D, De Jong PE (1993) Long-term benefits of the antiproteinuric effect of angiotensin-converting enzyme inhibition in nondiabetic renal disease. Am J Kidney Dis 22: 202–206
Trachtman H, Gauthier B (1988) Effect of angiotensin-convernting enzyme inhibitor therapy on proteinuria in children with renal disease. J Pediatr 112: 295–298
Millner DS, Morgenstern BZ (1991) Angiotensin converting enzyme inhibitors for reduction of proteinuria in children with steroid-resistant nephrotic syndrome. Prediatr Nephrol 5: 587–590
Ueda N, Kawaguchi S, Niinomi Y, Nonoda T, Ohnishi M, Ito S, Yasaki T (1986) Effect of dipyridamole treatment on proteinuria in pediatric renal disease. Nephron 44: 174–179
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Proesmans, W., Van Wambeke, I. & Van Dyck, M. Long-term therapy with enalapril in patients with nephrotic-range proteinuria. Pediatr Nephrol 10, 587–589 (1996). https://doi.org/10.1007/s004670050166
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DOI: https://doi.org/10.1007/s004670050166