Enalapril: antiproteinuric effect in children with nephrotic syndrome

Aim: The present study was designed to establish the antiproteinuric effect of ACE-I (enalapril). Patients and methods: Six children with steroid-resi stant nephrotic syndrome(SRNS) and one patient affected by Alport syndrome and nephrotic-range proteinuria received enalapril (mean dose 0.3 mg/kg/day ) during a mean period of 2 years. Before initiation of therapy, blood pres sure was normal in all but one patient, the latter showed normal values wit h enalapril treatment. Results: Five patients showed a significant increase of albumin levels after the: treatment. Creatinine clearance remained stab le during the study in all but one patient affected by Alport syndrome. Con clusion: In five patients (71.4%) enalapril therapy resulted in an importan t reduction of proteinuria, in one patient the treatment was stopped after one year for relapse. In patient with Alport syndrome the fall in creatinin e clearance, may simply reflect the natural course of the disease.