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Bryant CE, Rajai A, Webb NJA, et al. Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria. Pediatr Nephrol. 2021;36(10):3211-3219doi: 10.1007/s00467-021-05045-4.
Bryant, C. E., Rajai, A., Webb, N. J. A., & Hogg, R. J. (2021). Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria. Pediatric nephrology (Berlin, Germany), 36(10), 3211-3219. https://doi.org/10.1007/s00467-021-05045-4
Bryant, Charlotte E, et al. "Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria." Pediatric nephrology (Berlin, Germany) vol. 36,10 (2021): 3211-3219. doi: https://doi.org/10.1007/s00467-021-05045-4
Bryant CE, Rajai A, Webb NJA, Hogg RJ. Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria. Pediatr Nephrol. 2021 Oct;36(10):3211-3219. doi: 10.1007/s00467-021-05045-4. Epub 2021 Apr 21. PMID: 33881639; PMCID: PMC8445872.
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Pediatr Nephrol. 2021 Oct;36(10):3211-3219. doi: 10.1007/s00467-021-05045-4. Epub 2021 Apr 21.

Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria.

Pediatric nephrology (Berlin, Germany)

Charlotte E Bryant, Azita Rajai, Nicholas J A Webb, Ronald J Hogg

Affiliations

  1. Research and Innovation, Manchester University NHS Foundation Trust, Nowgen Building, Grafton St., Manchester, M13 9WU, UK. [email protected].
  2. Research and Innovation, Manchester University NHS Foundation Trust, Nowgen Building, Grafton St., Manchester, M13 9WU, UK.
  3. Centre for Biostatistics, Division of Population Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
  4. , Kailua Kona, Hawaii, USA.

PMID: 33881639 PMCID: PMC8445872 DOI: 10.1007/s00467-021-05045-4

Abstract

BACKGROUND: Studies have shown that losartan reduces serum uric acid in adults, unlike angiotensin-converting enzyme inhibitors. A previous study demonstrated that losartan and enalapril had comparable effects on proteinuria in children.

METHODS: We conducted a post hoc analysis of results from a prospective trial in which the proteinuria-reducing effects of losartan and enalapril were compared. We have now evaluated (a) the effects of these medications on SUA in 248 children with proteinuria and (b) the correlation between changes in SUA and eGFR.

RESULTS: SUA levels after 36 months were found to be increased when compared to baseline in both losartan and enalapril groups. The mean change in SUA from baseline was significantly different at 12 months between 23 hypertensive patients randomised to losartan (3.69% decrease [95% CI 11.31%, 3.93%]) and 24 randomised to enalapril (12.57% increase [95% CI 3.72%, 21.41%]), p = 0.007. This significant difference remained after 24, 30 and 36 months but was observed in the entire group of 248 patients only at 12 months. There was a statistically significant negative correlation between changes in SUA and changes in eGFR at each time point over 36 months.

CONCLUSIONS: Losartan may have long-term beneficial effects on SUA and eGFR in children with proteinuria.

© 2021. The Author(s).

Keywords: Children; Chronic kidney disease (CKD); Hypertension; Hyperuricemia; Proteinuria

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