Cel
ACE inhibitors are renoprotective in adults with chronic renal failure (CRF), but of unproven usefulness in children. In a randomised trial in 350 CRF children we will address if ACE inhibition is efficacious in slowing CRF progression in acquired and congenital nephropathies, if progression can be additionally influenced by intensified antihypertensive treatment achieving low-normal blood pressure, and which factors determine CRF progression and/or its susceptibility to ACE inhibition. Potential effects of renin-angiotensin system and PAI-l gene polymorphisms, mutations in genes defining glomerular structure or causing renal hypo/dysplasia, renal endothelnr-l turnover, plasma homocysteine and apolipoprotein phenotypes will be assessed. The cardiovascular consequences of childhood-onset CRF and renoprotective pharmacotherapy will be addressed by carotid ultrasound, echocardiography and 24-hour blood pressure monitoring.
Dziedzina nauki
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69115 HEIDELBERG
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