Antihypertensive effect and elimination kinetics of captopril in hypertensive children with renal disease

Sinaiko, Alan R.; Mirkin, Bernard L.; Hendrick, David A.; Green, Thomas P.; O’Dea, Robert F.

doi:10.1016/s0022-3476(83)80490-9

Cited by 60 publications

(26 citation statements)

References 18 publications

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“…We could find only one study in which children with various types of renal disease were treated exclusively with captopril for HTN, and the dose range was very wide (0.5-6.0 mg/kg per day) [11]. The dosing range for our patients treated with captopril was similar to that reported by Sinaiko et al [26]. In summary, the dosing range we used for CCB and ACEI is similar to that reported in the literature.…”

Section: Discussionsupporting

confidence: 81%

Treatment of primary and secondary hypertension in children

et al. 2006

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The incidence of pediatric hypertension (HTN) is increasing, mainly due to an increase in primary (essential) HTN, or PH. There are only a limited number of studies assessing the characteristics and treatment efficacy of PH versus secondary HTN (SH). We conducted a retrospective analysis of 158 pediatric patients (mean age: 10.8 years; sex ratio: 51.1% female, 48.9% male) with HTN of whom 34.4% had PH and 65.6% had SH. The vast majority were either African-American or Caucasian. Among all patients, therapy induced a significant decrease in systolic blood pressure (SBP) and diastolic BP (DBP) (both p<0.0001). SBP (p<0.0001) and DBP (p=0.002) declined significantly in PH patients. PH and SH patients with a body mass index (BMI) >95th percentile (%) had a significantly higher post-therapy SBP (both p<0.05) than those with a BMI <95th%. SBP declined similarly in PH patients treated with calcium-channel blockers (CCB) and angiotensin-converting enzyme inhibitors (ACEI). DBP declined only in PH patients treated with ACEI. SBP and DBP (both p<0.0001) declined significantly in SH patients. Post-therapy BP was similar in SH patients treated with either CCB or ACEI. Post-therapy SBP and DBP were significantly lower in SH patients than in PH patients; moreover, therapy induced a greater decline in SBP and DBP in the SH patients. Compared to PH patients, SH patients were twofold more likely to achieve a SBP less than the 95th% after therapy. We conclude that (1) significant lowering of BP with either CCB or ACEI is achievable in most children with HTN, and (2) SH patients respond better to therapy than those with PH.

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Section: Discussionsupporting

confidence: 81%

Treatment of primary and secondary hypertension in children

et al. 2006

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“…creased. [61] This alteration of metabolism is evident in the inBased on the study results a starting dose of 0.7 mg/kg (up to 5mg) creased serum concentrations of captopril found in hemodialysis once daily is appropriate for BP control in children aged 6-16 patients.…”

Section: Nonpharmacologic Managementmentioning

confidence: 83%

“…[70] tion. [61] Almost the entire dose of drug is excreted by the kidneys Safety and efficacy of lisinopril has been studied in children with a starting dose of 0.2 mg/kg and a maintenance dose of 1.5 aged 6-16 years (n = 115). [71] BP response was dose dependent mg/kg/day divided into two parts.…”

Section: Nonpharmacologic Managementmentioning

confidence: 99%

“…[65] Enalapril has been pre-existing renal dysfunction have been describused in the treatment of both proteinuria and HTN in corticosteed. [57,58,61,63,65,67,74,75] Transient anuria and renal insufficiency have roid-resistant idiopathic nephrotic syndrome, and reduced edema, also been reported in children with renal transplants (rise in serum hypoalbuminemia, and hypercholesterolemia through reduction of creatinine from 0.7 to 1.8 mg/dL) receiving ACEs; however, intraglomerular pressure via efferent arteriolar dilatation. [66] creatinine levels returned to normal with discontinuation of therEnalapril is effective both as monotherapy and when used with apy.…”

Section: Nonpharmacologic Managementmentioning

confidence: 99%

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Pharmacologic Treatment of Chronic Pediatric Hypertension

et al. 2005

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Improved recognition of the relationship between childhood and adult blood pressures and identification of end-organ damage in children, adolescents, and young adults with hypertension has led to increased focus by pediatricians and general practitioners on the detection, evaluation, and treatment of hypertension. Notably, detection, evaluation, and treatment of pediatric hypertension has increased significantly since the first Task Force Report on High Blood Pressure in Children and Adolescents in 1977 with advances in both nonpharmacologic and pharmacologic treatments.Angiotensin-converting enzyme inhibitors (e.g. captopril, enalapril, lisinopril, ramipril) and calcium channel antagonists (e.g. nifedipine, amlodipine, felodipine, isradipine) are the most commonly prescribed antihypertensive medications in children due to their low adverse-effect profiles. Diuretics (e.g. thiazide diuretics, loop diuretics, and potassium-sparing diuretics) are usually reserved as adjunct therapy. Newer agents, such as angiotensin receptor antagonists (e.g. irbesartan), are currently being studied in children and adolescents. These agents may be an option in children with chronic cough secondary to angiotensin-converting enzyme inhibitors. beta-Adrenoreceptor antagonists (e.g. propranolol, atenolol, metoprolol, and labetalol), alpha-adrenoreceptor antagonists, alpha-adrenoreceptor agonists, direct vasodilators, peripheral adrenoreceptor neuron agonists, and combination products are less commonly used in pediatric patients because of adverse events but may be an option in children unresponsive to calcium channel blockers, angiotensin converting-enzyme inhibitors, or angiotensin receptor blockers.

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“…[25] Sinaiko et al found elevated levels of renin in children treated with ACE-inhibitors, suggesting that suppression of renin by β-blockers in addition to ACEinhibition creates an even larger effect on IH regression. [25,38] No further evidence in literature could be found for this therapy. Adverse effects in this overview came from one study with eight patients showing a transient mild creatinine elevation in the first week of treatment in one of the patients.…”

Section: Ace-inhibitorsmentioning

confidence: 97%

Treatment of infantile hemangiomas: therapeutic options in regard to side effects and adverse events – a review of the literature

Raphaël

Breur

Vlasveld

et al. 2016

Expert Opinion on Drug Safety

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Introduction: While options for treatment strategies for infantile hemangiomas (IH) are numerous, evidence-based information about agents, optimal dosage, adverse effects, treatment modality, pretreatment and treatment strategies remain limited. Areas covered: To evaluate side effects and adverse events of medical treatment in children with infantile hemangioma, a comprehensive review of the literature was performed to provide information for daily practice. In total 254 studies were retrieved from medical databases and comprised 10,022 patients divided into 5 different treatment groups. Information about working mechanism, side effects and adverse events of therapies used as a single agent for IH are discussed and evaluated according to information from pharmacotherapeutic databases. Randomized controlled trials have only scarcely been performed for the many therapeutic options reported for IH. Short-and long-term side effects and adverse events, have not been systematically studied. Subsequently information about the medical treatment options and pharmacotheraputic databases for therapy in children with IH are incomplete. Expert opinion: From the many therapeutic options, propranolol is the first-line approach for IH, predominantly based on clinical observation, efficacy and tolerability in the short-term. The unsolved ravels of possible short and long-term adverse events of propranolol used during early developmental stages of children need thorough review.

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Antihypertensive effect and elimination kinetics of captopril in hypertensive children with renal disease

Cited by 60 publications

References 18 publications

Treatment of primary and secondary hypertension in children

Treatment of primary and secondary hypertension in children

Pharmacologic Treatment of Chronic Pediatric Hypertension

Treatment of infantile hemangiomas: therapeutic options in regard to side effects and adverse events – a review of the literature

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