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Ramipril in the treatment of proteinuria in children after renal transplantation
Author(s) -
Seeman Tomáš,
Dušek Jiří,
Vondrák Karel,
Janda Jan
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2009.01216.x
Subject(s) - proteinuria , medicine , ramipril , transplantation , renal function , urology , creatinine , hyperkalemia , endocrinology , kidney , blood pressure
Seeman T, Dušek J, Vondrák K, Janda J. Ramipril in the treatment of proteinuria in children after renal transplantation.
Pediatr Transplantation 2010:14:283–287. © 2009 John Wiley & Sons A/S. Abstract: The efficacy and safety of ACEI in adult patients with hypertension and proteinuria after renal transplantation is proven however data on the effectiveness of ACEI in transplanted children are rare. The aim of the present study was to investigate the effect of ramipril on proteinuria and BP in children after R‐Tx. Twelve transplanted children (median age 15.3 yr, median time after R‐Tx 4.5 yr) with proteinuria with or without hypertension were prospectively treated with ramipril for six months. Proteinuria was assessed as protein/creatinine ratio. Office BP was evaluated and hypertension defined as BP ≥95th centile. Graft function was assessed (Schwartz formula). The starting dose of ramipril was 1.5 mg/m 2 /24‐h. Proteinuria declined in 92% of children from a median 39 to 22 mg/mmol creatinine (p < 0.01). The median decline of proteinuria was 9 mg/mmol creatinine, it reached 23% of the initial values. The prevalence of hypertension did not change significantly (50% initially vs. 33% after six months). Graft function and serum potassium level did not change significantly, two children developed mild hyperkalemia. Ramipril can reduce proteinuria in most transplanted children; its antiproteinuric effect is exhibited even without BP lowering effect.