Losartan and enalapril are comparable in reducing proteinuria in children
| Autor: | R. Massaad, Shahnaz Shahinfar, Nicholas J. A. Webb, Chun Lam, Christine McCrary Sisk, Gilbert W. Gleim, Emanuela P. Santoro, Thomas G. Wells |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Time Factors 030232 urology & nephrology Angiotensin-Converting Enzyme Inhibitors urologic and male genital diseases chemistry.chemical_compound 0302 clinical medicine Enalapril Child Proteinuria Age Factors clinical trial female genital diseases and pregnancy complications 3. Good health Treatment Outcome Losartan Tolerability Nephrology Child Preschool Creatinine Female medicine.symptom hormones hormone substitutes and hormone antagonists Glomerular Filtration Rate circulatory and respiratory physiology medicine.drug medicine.medical_specialty Adolescent Urology Renal function 03 medical and health sciences children 030225 pediatrics Internal medicine medicine Humans Amlodipine Cystatin C Least-Squares Analysis Renal Insufficiency Chronic business.industry medicine.disease Endocrinology chemistry business Angiotensin II Type 1 Receptor Blockers chronic kidney disease Biomarkers Kidney disease |
| Zdroj: | Kidney International. 82:819-826 |
| ISSN: | 0085-2538 |
| Popis: | Angiotensin-converting enzyme inhibitors and angiotensin II type I receptor blockers delay progression of chronic kidney disease and have antiproteinuric effects beyond their effects on blood pressure. They are routinely used in adults; however, their efficacy and safety in children, in whom the causes of chronic kidney disease are significantly different relative to adults, is uncertain. Here we assessed an open-label extension of a previous 3-month blinded trial, in which the efficacy and tolerability of losartan was compared to placebo or amlodipine in 306 normotensive and hypertensive children with proteinuria. In this study, 268 children were re-randomized to losartan or enalapril and followed until 100 patients completed 3 years of follow-up for proteinuria and renal function. The least squares percent mean reduction from baseline in the urinary protein/creatinine ratio was 30.01% for losartan and 40.45% for enalapril. The least squares mean change from baseline in eGFR was 3.3 ml/min per 1.73 m2 for losartan and 7.0 ml/min per 1.73 m2 for enalapril. The incidence of specific adverse events such as hyperkalemia and renal dysfunction was low and similar in both groups. Both were generally well tolerated and, overall, fewer drug-related adverse events occurred with losartan than with enalapril. Thus, in children with proteinuria, losartan and enalapril significantly reduced proteinuria without any appreciable changes in eGFR, effects that were maintained throughout the study. Both losartan and enalapril were generally well tolerated. |
| Databáze: | OpenAIRE |
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