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Angiotensin receptor blocker reduces proteinuria independently of blood pressure in children already treated with Angiotensin-converting enzyme inhibitors.
Kidney Blood Press Res. 2009; 32(6):440-4.KB

Abstract

BACKGROUND/AIMS

Dual blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has higher antiproteinuric effects than single blockade in adults. In children, little is known on dual blockade of the renin-angiotensin system. The study investigates whether adding an ARB to proteinuric children already on ACEI reduces proteinuria.

METHODS

A total of 10 children (median age 13.3 years) with chronic kidney disease and persistent proteinuria despite maximal dose of ACEI were included. Losartan was given at an initial dose 0.8 mg/kg/day. Proteinuria, blood pressure (BP) and renal function (glomerular filtration rate) were measured.

RESULTS

Mean proteinuria decreased from 484 +/- 290 mg/mmol creatinine to 223 +/- 197 after 1-3 months of losartan treatment and remained stable at 234 +/- 153, 224 +/- 177 and 195 +/- 133 after 3-6, 6-12 months and at the last follow-up check (median 1.9 years, p < 0.05 for all visits vs. before treatment). The median percentage decrease in proteinuria was 66, 56, 44 and 66% during the study periods. No significant change in BP, glomerular filtration rate or serum potassium was observed. One child complained of rash, which led to discontinuation of losartan.

CONCLUSION

Adding an ARB to current ACEI treatment can further reduce proteinuria in children with chronic kidney disease without affecting BP.

Authors+Show Affiliations

Department of Pediatrics, 2nd School of Medicine, Charles University Prague, Prague, Czech Republic. tomas.seeman@lfmotol.cuni.czNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20016211

Citation

Seeman, Tomás, et al. "Angiotensin Receptor Blocker Reduces Proteinuria Independently of Blood Pressure in Children Already Treated With Angiotensin-converting Enzyme Inhibitors." Kidney & Blood Pressure Research, vol. 32, no. 6, 2009, pp. 440-4.
Seeman T, Pohl M, Misselwitz J, et al. Angiotensin receptor blocker reduces proteinuria independently of blood pressure in children already treated with Angiotensin-converting enzyme inhibitors. Kidney Blood Press Res. 2009;32(6):440-4.
Seeman, T., Pohl, M., Misselwitz, J., & John, U. (2009). Angiotensin receptor blocker reduces proteinuria independently of blood pressure in children already treated with Angiotensin-converting enzyme inhibitors. Kidney & Blood Pressure Research, 32(6), 440-4. https://doi.org/10.1159/000266478
Seeman T, et al. Angiotensin Receptor Blocker Reduces Proteinuria Independently of Blood Pressure in Children Already Treated With Angiotensin-converting Enzyme Inhibitors. Kidney Blood Press Res. 2009;32(6):440-4. PubMed PMID: 20016211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Angiotensin receptor blocker reduces proteinuria independently of blood pressure in children already treated with Angiotensin-converting enzyme inhibitors. AU - Seeman,Tomás, AU - Pohl,Michael, AU - Misselwitz,Joachim, AU - John,Ulrike, Y1 - 2009/12/17/ PY - 2009/08/31/received PY - 2009/11/28/accepted PY - 2009/12/18/entrez PY - 2009/12/18/pubmed PY - 2010/5/1/medline SP - 440 EP - 4 JF - Kidney & blood pressure research JO - Kidney Blood Press Res VL - 32 IS - 6 N2 - BACKGROUND/AIMS: Dual blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has higher antiproteinuric effects than single blockade in adults. In children, little is known on dual blockade of the renin-angiotensin system. The study investigates whether adding an ARB to proteinuric children already on ACEI reduces proteinuria. METHODS: A total of 10 children (median age 13.3 years) with chronic kidney disease and persistent proteinuria despite maximal dose of ACEI were included. Losartan was given at an initial dose 0.8 mg/kg/day. Proteinuria, blood pressure (BP) and renal function (glomerular filtration rate) were measured. RESULTS: Mean proteinuria decreased from 484 +/- 290 mg/mmol creatinine to 223 +/- 197 after 1-3 months of losartan treatment and remained stable at 234 +/- 153, 224 +/- 177 and 195 +/- 133 after 3-6, 6-12 months and at the last follow-up check (median 1.9 years, p < 0.05 for all visits vs. before treatment). The median percentage decrease in proteinuria was 66, 56, 44 and 66% during the study periods. No significant change in BP, glomerular filtration rate or serum potassium was observed. One child complained of rash, which led to discontinuation of losartan. CONCLUSION: Adding an ARB to current ACEI treatment can further reduce proteinuria in children with chronic kidney disease without affecting BP. SN - 1423-0143 UR - https://www.unboundmedicine.com/medline/citation/20016211/Angiotensin_receptor_blocker_reduces_proteinuria_independently_of_blood_pressure_in_children_already_treated_with_Angiotensin_converting_enzyme_inhibitors_ L2 - https://www.karger.com?DOI=10.1159/000266478 DB - PRIME DP - Unbound Medicine ER -