Abstract | OBJECTIVE: DESIGN: Open-label, randomized controlled trial. SETTING: Pediatric nephrology clinic at a tertiary-care referral hospital. INTERVENTION: Children with GFR between 15-60 mL/min/1.73 m2 were randomized to receive either enalapril at 0.4 mg/kg /day or no enalapril for 1 year. OUTCOME MEASURES: Change in GFR using 99mTc-DTPA and urine protein to creatinine ratio. Secondary outcomes included occurrence of composite outcome (30% decline in GFR or end stage renal disease) and systolic and diastolic blood pressure SDS during the study period. RESULTS: 41 children were randomized into two groups; 20 received enalapril while 21 did not receive enalapril. During 1 year, GFR decline was not different in the two groups (regression coefficient (r) 0.40, 95% CI -4.29 to 5.09, P=0.86). The mean proteinuria reduction was 65% in the enalapril group, significantly higher than control group. The difference was significant even after adjustment for blood pressure was 198.5 (CI 97.5, 299.3; P<0.001). 3 (17.6%) patients in enalapril and 7 (36.8%) in non- enalapril group attained the composite outcome. CONCLUSIONS:
Enalapril is effective in reducing proteinuria in children with CKD and might be renoprotective in proteinuric CKD.
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Authors | Pankaj Hari, Jitender Sahu, Aditi Sinha, Ravinder Mohan Pandey, Chandra Shekhar Bal, Arvind Bagga |
Journal | Indian pediatrics
(Indian Pediatr)
Vol. 50
Issue 10
Pg. 923-8
(Oct 2013)
ISSN: 0974-7559 [Electronic] India |
PMID | 23585423
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antihypertensive Agents
- Enalapril
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Topics |
- Adolescent
- Antihypertensive Agents
(therapeutic use)
- Child
- Child, Preschool
- Enalapril
(therapeutic use)
- Female
- Glomerular Filtration Rate
(drug effects)
- Humans
- Male
- Prospective Studies
- Proteinuria
(drug therapy, physiopathology, urine)
- Renal Insufficiency, Chronic
(drug therapy, physiopathology, urine)
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