Effect of ramipril on ambulatory blood pressure and albuminuria in renal hypertension
| Autor: | Karl Schärer, Elke Wühl, M. Verho, L. Teichert, Jutta Gellermann, Marianne Soergel |
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| Rok vydání: | 2000 |
| Předmět: |
Ramipril
Adult Male medicine.medical_specialty Ambulatory blood pressure Hypertension Renal Adolescent Systole Urology Renal function Angiotensin-Converting Enzyme Inhibitors Blood Pressure chemistry.chemical_compound Diastole Internal medicine medicine Albuminuria Humans Child Creatinine business.industry Blood Pressure Monitoring Ambulatory medicine.disease Blood pressure Endocrinology chemistry Nephrology Child Preschool Pediatrics Perinatology and Child Health ACE inhibitor Female medicine.symptom business medicine.drug Kidney disease Glomerular Filtration Rate |
| Zdroj: | Pediatric nephrology (Berlin, Germany). 15(1-2) |
| ISSN: | 0931-041X |
| Popis: | Inhibition of the angiotensin-converting enzyme (ACE) exerts a renoprotective effect in adult patients with chronic kidney disease. We evaluated prospectively changes in blood pressure (BP), protein excretion and renal function after administration of the long-acting ACE inhibitor ramipril as monotherapy during 6 months in 14 moderately hypertensive children aged 5–18 years with various nephropathies. Four patients initially had a decreased glomerular filtration rate (GFR below 60 ml/min/1.73 m2). BP was evaluated by ambulatory 24-h monitoring. After 2 weeks of treatment by oral ramipril (1.5 mg/m2 once daily), mean values of systolic and diastolic 24-h ambulatory BP fell by more than 5 mmHg in nine patients. In eight patients the dose was doubled. At the end of the study systolic BP was below the 95th percentile in 9 and diastolic BP in 13 patients. The initially reduced nocturnal dip increased significantly. Of 11 patients with an increased albumin excretion (median 1.3 g/g creatinine), 6 responded to ramipril by a median reduction of 78% (range 24–83%), whilst in 5 albuminuria increased (median +19%). GFR was well preserved and no other adverse effects from the drug were noted. The study demonstrates that ramipril is an efficacious antihypertensive agent in children with renal hypertension. It is well tolerated, even in mild renal insufficiency. In addition, the drug has a persistent antiproteinuric action in about half of the patients contributing to conserve renal function. |
| Databáze: | OpenAIRE |
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