CLINICAL STUDY OF FOSINOPRIL IN CHILDREN WITH STEROIDRESISTANT NEPHROTIC SYNDROME

Li Zhi-Hui, Yi Zhu-Wen

Laboratory of Pediatric Nephrology, The Second Hospital of Xiang Ya School of Medicine, Central South University, Changsha, China

 

Objective: In order to investigate the relation between the renin-angiotensin system (RAS) and progressive renal injury and study the treatment effects of ACE inhibitors in children with steroid-resistant nephrotic syndrome.

Methods:30 boys and 15 girls with steroid-resistant nephrotic syndrome were randomly divided into two groups: group: Treated with fosinopril and prednisone. Group: Treated with prednisone. 24h urinary protein was measured every 4 weeks until week 12. Cholesterol (CHO), triglyceride(TG), high density lipoprotein(HDL) and low density lipoprotein(LDL) in serum were measured at the beginning and the end of the study. Serum ACE was measured. Renin activity (PRA) and angiotensin (AT) in blood were detected. Retinol-binding protein (RBP) andβ2-microglobulin(β2-MG) were measured at the beginning and the end of the study. Ten healthy children served as control subjects.

Results: Serum levels of ACE, PRA and AT in steroid-resistant nephrotic syndrome  had no difference versus health subjects. It had no difference at the beginning of the study compared with the end. At 4 weeks, 8 weeks and 12 weeks, 24h urinary protein was lower in the groupthan in the group(P0.01). At the end of study, the difference between group and group was significant in  the level of serum CHO, TG and HDL (P<0.01). At the end of the study, the levels of urine RBP andβ2-MG in the groupⅠ were lower than in the group(P<0.01.).

Conclusions: RAS activity of systemic circulation was normal and did not changed after long time ACEI treatment, but RAS activity of renal may be increased in children with steroid-resistant nephrotic syndrome. ACEI could diminish 24h urinary protein, regulated the blood-lipid and remitted tubulointerstitium injury.

 

 
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