Renoprotection in children with congenital anomalies of kidney and urinary tract

Authors

Keywords:

renoprotection, congenital anomalies of kidney and urinary tract, children, chronic kidney disease, enalapril

Abstract

Objective: to assess the effect of 5-year renoprotective therapy on slowing down the progression of chronic kidney disease (CKD) in children with congenital anomalies of kidney and urinary tract (CAKUT).
Materials and methods. The study involved 69 patients with CAKUT and CKD of stages 1–3 (3a and 3b) aged 2 to 17 (8.3±0.5). The renoprotective therapy for CAKUT patients was prescribed taking into account and subject to control of the glomerular filtration rate (GFR), serum cystatin C, albumin excretion rate (AER), albumin/creatinine ratio (ACR), and serum potassium rate, in accordance with the proposed algorithm of using the antagonists of the renin-angiotensin-aldosterone system (RAAS) in CKD patients. Patients with CKD of stages 1–2 were prescribed monotherapy with enalapril at 0.2–0.4 mg/kg daily. Patients with CKD of stage 3 (3a and 3b) were prescribed monotherapy with enalapril or fosinopril at 0.1–0.2 mg/kg daily.
Results. 5-year experience of using renoprotection in children with CAKUT allowed slowing down CKD progression in 96.4% of patients with CKD stage 1, in 91.2% of patients with CKD stage 2 and in 71.4% of patients with CKD stage 3 (3a and 3b).
Conclusions. In CAKUT patients with CKD of stages 1–3 (3a and 3b), the anti_RAAS therapy has proven its renoprotective efficacy and safety.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. Informed consent was obtained from the parents of the children (or their guardians) for the research.

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