Arch Dis Child. Published Online First: 19 February 2008. doi:10.1136/adc.2008.138982
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Should Angiotensin converting enzyme inhibitors be used in children with Type 1 diabetes and Microalbuminuria?
1 University of Cambridge, United Kingdom
* To whom correspondence should be addressed. E-mail: rmw33{at}cam.ac.uk.
Accepted 7 February 2008
Abstract
A 14 yr-old girl with type-1 diabetes (T1D) attends clinic for her annual review appointment. An albumin creatinine ratio (ACR) on spot urine is 7.3mg/mmol. Her blood pressure is 125/67 and HbA1c 9.2%. Subsequently, three consecutive early morning urine samples have ACR of 6.8, 5.7 and 7.3 mg/mmol, respectively and when repeated a further 3 and 6 months later, they remain elevated. You are aware that in adult women with diabetes persistent microalbuminuria (MA) is defined as an ACR greater than 3.5 mg/mmol on 2 out of 3 successive occasions, and that in such adults, treatment with angiotensin converting enzyme inhibitors (ACEi) confers renoprotection. You wonder whether your patient should be treated.
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