Simonetti Giacomo D, von Vigier Rodo O, Konrad Martin, Rizzi Mattia, Fossali Emilio, Bianchetti Mario G
Department of Pediatrics, Inselspital, Bern, Switzerland.
Pediatr Nephrol. 2006 Oct;21(10):1480-2. doi: 10.1007/s00467-006-0144-0. Epub 2006 Jun 27.
The angiotensin II receptor blockers irbesartan and losartan effectively reduce blood pressure and proteinuria in childhood. We were impressed by the neutral taste and the small size of the candesartan cilexetil tablets. This angiotensin II receptor blocker was used during 4 months in 17 pediatric patients (aged 0.5-16, median 4.5 years) with chronic arterial hypertension (n=6), overt proteinuria (n=2), or both (n=9). The initial candesartan dose of 0.23 (0.16-0.28) mg/kg body weight once daily (median and interquartile ranged) was doubled in ten patients [final dose 0.35 (0.22-0.47) mg/kg body weight]. No adverse clinical experiences were noted on candesartan. Candesartan increased plasma potassium by 0.3 (0.0-0.8) mmol/l (P<0.01). In children with arterial hypertension, blood pressure decreased by 9 (3-13)/9 (3-18) mmHg (P<0.01); in those with overt proteinuria the urinary albumin/creatinine ratio decreased by 279 (33-652) mg/mmol (P<0.05). In conclusion, in children candesartan reduces blood pressure and proteinuria with an excellent short-term tolerability profile.
血管紧张素II受体阻滞剂厄贝沙坦和氯沙坦可有效降低儿童的血压和蛋白尿。坎地沙坦酯片无味且体积小，给我们留下了深刻印象。17例患有慢性动脉高血压（n = 6）、显性蛋白尿（n = 2）或两者兼而有之（n = 9）的儿科患者（年龄0.5 - 16岁，中位数4.5岁）使用这种血管紧张素II受体阻滞剂4个月。坎地沙坦的初始剂量为0.23（0.16 - 0.28）mg/kg体重，每日一次（中位数和四分位间距），10例患者的剂量加倍[最终剂量0.35（0.22 - 0.47）mg/kg体重]。未发现与坎地沙坦相关的不良临床事件。坎地沙坦使血浆钾升高0.3（0.0 - 0.8）mmol/l（P<0.01）。在患有动脉高血压的儿童中，血压下降了9（3 - 13）/9（3 - 18）mmHg（P<0.01）；在患有显性蛋白尿的儿童中，尿白蛋白/肌酐比值下降了279（33 - 652）mg/mmol（P<0.05）。总之，在儿童中，坎地沙坦可降低血压和蛋白尿，且短期耐受性良好。
