Display options
Cite
Bajpai M, Chaturvedi PK, Bal CS, et al. Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery. J Indian Assoc Pediatr Surg. 2013;18(2):74-8doi: 10.4103/0971-9261.109357.
Bajpai, M., Chaturvedi, P. K., Bal, C. S., Sharma, M. C., & Kalaivani, M. (2013). Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery. Journal of Indian Association of Pediatric Surgeons, 18(2), 74-8. https://doi.org/10.4103/0971-9261.109357
Bajpai, Minu, et al. "Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery." Journal of Indian Association of Pediatric Surgeons vol. 18,2 (2013): 74-8. doi: https://doi.org/10.4103/0971-9261.109357
Bajpai M, Chaturvedi PK, Bal CS, Sharma MC, Kalaivani M. Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery. J Indian Assoc Pediatr Surg. 2013 Apr;18(2):74-8. doi: 10.4103/0971-9261.109357. PMID: 23798811; PMCID: PMC3687151.
Copy Download .nbib Format: NLM
Share it on

J Indian Assoc Pediatr Surg. 2013 Apr;18(2):74-8. doi: 10.4103/0971-9261.109357.

Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery.

Journal of Indian Association of Pediatric Surgeons

Minu Bajpai, Pradeep K Chaturvedi, Chandra S Bal, Meher C Sharma, Mani Kalaivani

Affiliations

  1. Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

PMID: 23798811 PMCID: PMC3687151 DOI: 10.4103/0971-9261.109357

Abstract

AIM: To study renin angiotensin system (RAS) activity after posterior urethral valve ablation and the role of early induction of angiotensin converting enzyme-inhibitors (ACE-I) on the outcome of renal function.

MATERIALS AND METHODS: Thirty four children underwent valve ablation in which therapy with ACE-I was started 40.5 ± 4.1 (range 32-47 months) formed the study group. Post-ACE-I data were collected after mean duration of 18.2 ± 4.0 (12-28 months). Plasma renin activity (PRA), urinary micro albumin, glomerular filtration rate (GFR), and serum creatinine, before and after therapy were monitored.

RESULTS: Therapy with ACE-I resulted in a fall in micro albuminuria by 45.7% and 42.0% in patients without and with vesico ureteral reflux, respectively, and improvement in split renal function by 6.6% and 5.9% GFR respectively. A similar response was noted in patients without and with renal scars.

CONCLUSION: The decline in renal function after valve ablation is accompanied by activation of RAS reflected in a gradual rise in PRA. Therapy with ACE-I stabilizes and then improves renal function, thereby, retarding the pace of renal damage.

Keywords: Angiotensin converting enzyme-inhibitors; glomerular filtration rate; microalbuminuria; plasma renin activity; posterior urethral valves; renal scars

References

  1. Pediatr Surg Int. 2001;17(1):11-5 - PubMed
  2. J Urol. 2005 Feb;173(2):592-4 - PubMed
  3. Lancet. 1997 Jun 28;349(9069):1857-63 - PubMed
  4. J Clin Invest. 1980 Feb;65(2):400-12 - PubMed
  5. J Clin Hypertens (Greenwich). 2011 Sep;13(9):667-75 - PubMed
  6. Adv Ren Replace Ther. 2001 Jul;8(3):157-63 - PubMed
  7. Pediatrics. 2001 May;107(5):1004-10 - PubMed
  8. Pediatr Surg Int. 1998 Jul;13(5-6):396-9 - PubMed
  9. J Urol. 1996 Oct;156(4):1450-4 - PubMed
  10. Lab Invest. 1992 Mar;66(3):265-84 - PubMed
  11. Pediatr Clin North Am. 1987 Oct;34(5):1187-207 - PubMed
  12. Urol Clin North Am. 1990 May;17(2):343-60 - PubMed
  13. J Mol Cell Cardiol. 1995 Aug;27(8):1545-60 - PubMed
  14. Ann Intern Med. 1997 Sep 1;127(5):337-45 - PubMed
  15. Br J Urol. 1988 Jul;62(1):59-62 - PubMed
  16. Kidney Int. 2003 Nov;64(5):1643-7 - PubMed
  17. J Am Soc Nephrol. 2002 Nov;13 Suppl 3:S190-5 - PubMed
  18. Cell Regul. 1991 Mar;2(3):219-27 - PubMed
  19. Ann Intern Med. 2002 Apr 16;136(8):604-15 - PubMed
  20. Pediatr Nephrol. 1996 Aug;10(4):422-34 - PubMed

Publication Types