Antiproteinuric action of amiloride in paediatric patient with corticoresistant nephrotic syndrome

Abstract

Introduccion: In nephrotic syndrome, increased podocyturia accompanies pathologic proteinuria. The therapeutic regimen with enalapril, losartan and amiloride could reduce both variables.

Objetives: Evaluate the anti-proteinuric effect of 2 non-immunological therapeutic regimens, the quantitative relationship between podocyturia and proteinuria.

Material and methods: We included children aged 4 to 12 years with corticoresistant nephrotic syndrome, using 2 different schemes: group A, enalapril+losartan, and group B, enalapril+losartan+amiloride.

Results: In group A, 17 patients completed the study, the initial mean proteinuria was 39mg/m²/h and mean proteinuria at the end was 24mg/m²/h, while in group B 14 patients were treated and the initial average proteinuria was 36mg/m²/h and the end average proteinuria was 13mg/m²/h. The paired T test showed significant differences in the decrease in proteinuria, for patients in group B without variation in podocyturia. The 2 factors associated with an increase in proteinuria were podocyturia and the time elapsed from the diagnosis of cortico-resistant nephrotic syndrome to the start of treatment anti-proteinuric.

Conclusions: The use of amiloride decreased proteinuria, without significantly modifying podocyturia; we did not observe a positive relationship between both variables.

Keywords: Amiloride; Enalapril; Losartan; Losartán; Nephrotic syndrome; Síndrome nefrótico.