Antiproteinuric action of amiloride in paediatric patient with corticoresistant nephrotic syndrome

In nephrotic syndrome, increased podocyturia accompanies pathologic proteinuria. The therapeutic regimen with enalapril, losartan and amiloride could reduce both variables. Evaluate the anti-proteinuric effect of 2 non-immunological therapeutic regimens, the quantitative relationship between podocyturia and proteinuria. We included children aged 4–12 years with corticoresistant nephrotic syndrome, using 2 different schemes: group A, enalapril + losartan, and group B, enalapril + losartan + amiloride. In group A, 17 patients completed the study, the initial mean proteinuria was 39 mg/m2/h and mean proteinuria at the end was 24 mg/m2/h, while in group B 14 patients were treated and the initial average proteinuria was 36 mg/m2/h and the end average proteinuria was 13 mg/m2/h. The paired T test showed significant differences in the decrease in proteinuria, for patients in group B without variation in podocyturia. The 2 factors associated with an increase in proteinuria were podocyturia and the time elapsed from the diagnosis of cortico-resistant nephrotic syndrome to the start of treatment anti-proteinuric. The use of amiloride decreased proteinuria, without significantly modifying podocyturia; we did not observe a positive relationship between both variables. En el síndrome nefrótico, la podocituria aumentada acompaña a la proteinuria patológica. El tratamiento con enalapril, losartán y amiloride podría reducir ambas variables. Evaluamos el efecto antiproteinúrico de 2 esquemas terapéuticos no inmunológicos, la relación cuantitativa entre la podocituria y la proteinuria, y las variables de riesgo asociadas con la proteinuria. Incluimos niños de 4 a 12 años de edad con síndrome nefrótico corticorresistente, utilizando 2 esquemas terapéuticos distintos: grupo A, enalapril + losartán, y grupo B, enalapril + losartán + amiloride. En el grupo A finalizaron el estudio 17 pacientes, la proteinuria promedio inicial fue de 39 mg/m2/h y la proteinuria media al finalizar fue de 24 mg/m2/h, en tanto que en el grupo B tratamos a 14 pacientes, la proteinuria promedio inicial fue de 36 mg/m2/h y la proteinuria promedio final de 13 mg/m2/h, y si bien ningún paciente redujo su proteinuria a valores fisiológicos, tanto la prueba t apareada (11,5, p