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Angiotensin converting enzyme inhibitor therapy to decrease microalbuminuria in normotensive children with

J Cook1, D Daneman, M Spino

  • 1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

The Journal of Pediatrics
|July 1, 1990
PubMed
Summary

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Captopril significantly reduced albumin excretion in children with type 1 diabetes and microalbuminuria. This treatment shows promise for preserving kidney function in diabetic adolescents.

Area of Science:

  • Nephrology
  • Pediatric Endocrinology
  • Diabetology

Background:

  • Microalbuminuria is an early sign of diabetic nephropathy in children.
  • Preserving renal function is crucial for long-term health in adolescents with diabetes.

Purpose of the Study:

  • To evaluate the efficacy of captopril in reducing microalbuminuria in normotensive children with insulin-dependent diabetes mellitus.
  • To assess the impact of captopril on renal function and blood pressure in this population.

Main Methods:

  • A double-blind, placebo-controlled, crossover trial was conducted.
  • 12 normotensive adolescents with insulin-dependent diabetes mellitus received either captopril (0.9 mg/kg/day) or placebo for 3 months.
  • Albumin excretion rate, plasma renin activity, mean arterial pressure, glomerular filtration rate, and renal plasma flow were measured.

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Main Results:

  • Captopril significantly decreased albumin excretion rate by 41% compared to placebo (p < 0.001).
  • Plasma renin activity increased, and mean arterial pressure slightly decreased during captopril therapy.
  • Glomerular filtration rate and renal plasma flow remained stable; Hemoglobin A1c values were unchanged.

Conclusions:

  • Short-term captopril treatment effectively reduces albumin excretion in children with type 1 diabetes and microalbuminuria.
  • Captopril appears safe and well-tolerated in this population.
  • Longer-term studies are needed to determine if captopril can prevent overt nephropathy.