[Efficacy of Enalapril in patients with single kidney and with or without normoprotein diet].

INTRODUCTION The patient with a solitary kidney and free protein intake can present pathological microalbuminuria. OBJECTIVE To evaluate the efficacy of Enalapril in patients with single kidney and with or without normoprotein diet. MATERIALS AND METHODS We studied 49 patients, mean age 11 years, eutrophics, with normal renal function and with approved medical consent. The exclusion criteria were: uropathies, arterial hypertension, malignant diseases, orthostatic proteinuria and previous treatments with nephrotoxics drugs. Patients were classified in two groups: Group A: with normoprotein diet (0.8 to 1.2 g/kg/day). Group B: with free protein intake. The patients with abnormal microalbuminuria received Enalapril (doses between 0.1-0.3 mg/kg/ day). RESULTS Group A: 21 patients, 2 with abnormal microalbuminuria. Mean increase of the renal size 14% (SD 8), risk of presenting pathological microalbuminuria: 9%. Group B: 28 patients, 11 with pathological microalbuminuria. Mean increase of the renal size: 33.8% (SD 6.1), risk of presenting abnormal microalbuminuria: 40%. RR: 4.125 (CI 1-16) (p: 0.01). NND: 3. Mean range of microalbuminuria pre- Enalapril 50 microg/min and post-Enalapril 11 microg/ min. Mean doses of Enalapril: 0.2 mg/kg/day. Correlation coefficient between increase of renal size and microalbuminuria range: 0.75 and between increase renal size and protein intake: 0.72. Mean time to reach abnormal microalbuminuria: 81 months (DS 7). CONCLUSION Enalapril together with the normoprotein diet in patient with single kidney reduces the risk of developing abnormal microalbuminuria.