Archives of Disease in Childhood 2008;93:633-635
Archimedes
Question 3
SHOULD ANGIOTENSIN CONVERTING ENZYME INHIBITORS BE USED IN CHILDREN WITH TYPE 1 DIABETES AND MICROALBUMINURIA?
1 University of Cambridge Department of Paediatrics, Addenbrooke’s Hospital, Cambridge, UK
2 University of Cambridge Department of Paediatrics, Box 116, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK; rmw33@cam.ac.uk
3 University of Cambridge Department of Paediatrics, Addenbrooke’s Hospital, Hills Road, Cambridge, UK
| The first 150 words of the full text of this article appear below. |
A 14-year-old girl with type 1 diabetes mellitus (DM) attends clinic for her annual review appointment. An albumin creatinine ratio (ACR) on spot urine is 7.3 mg/mmol. Her blood pressure is 125/67 and HbA1c is 9.2%. Subsequently, three consecutive early morning urine samples have ACR of 6.8, 5.7 and 7.3 mg/mmol, respectively, and remain elevated when repeated 3 and 6 months later. You are aware that in adult women with diabetes persistent microalbuminuria (MA) is defined as an ACR greater than 3.5 mg/mmol on two out of three successive occasions, and that in such adults, treatment with angiotensin converting enzyme inhibitors (ACEi) confers renoprotection. You wonder whether your patient should be treated.
In children with type 1 diabetes with persistent microalbuminuria [patient], does the use of ACEi [intervention] reduce urinary albumin excretion rate [outcome]?
Secondary sources: Cochrane database and BestBETs were searched using the term "Angiotensin" in the
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