[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.