Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation
Congenital nephrotic syndrome (NS) is characterized by early-onset heavy proteinuria. Most cases of congenital NS are associated with genetic mutations in the podocyte proteins. The causal relationship of perinatal infections with congenital NS has not yet been proven. Inadequate response to the tre...
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Format: | Article |
Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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Series: | Saudi Journal of Kidney Diseases and Transplantation |
Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2023;volume=34;issue=5;spage=462;epage=467;aulast= |
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author | Nimisha Dange Kiran P Sathe Alpana Kondekar Vishal Sawant |
author_facet | Nimisha Dange Kiran P Sathe Alpana Kondekar Vishal Sawant |
author_sort | Nimisha Dange |
collection | DOAJ |
description | Congenital nephrotic syndrome (NS) is characterized by early-onset heavy proteinuria. Most cases of congenital NS are associated with genetic mutations in the podocyte proteins. The causal relationship of perinatal infections with congenital NS has not yet been proven. Inadequate response to the treatment of such infections should prompt us to conduct genetic testing for congenital NS. The heavy proteinuria associated with congenital NS is usually difficult to control with conventional treatment. It often results in progressive kidney disease with a high risk of mortality in early life. Here, we describe an infant who developed congenital NS and was found to have a coexisting Cytomegalovirus infection and an underlying NPSH1 mutation. Proteinuria did not respond to a standard dose of enalapril. A supramaximal dose of enalapril was tried and was effective and safe in controlling the proteinuria. It was associated with improved growth, complete resolution of edema, normal serum albumin, and normal renal function beyond 2 years of age. |
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format | Article |
id | doaj.art-2c7ab763f4094bd9aedc1dfaa590013d |
institution | Directory Open Access Journal |
issn | 1319-2442 |
language | English |
last_indexed | 2024-04-24T19:36:08Z |
publishDate | 2023-01-01 |
publisher | Wolters Kluwer Medknow Publications |
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series | Saudi Journal of Kidney Diseases and Transplantation |
spelling | doaj.art-2c7ab763f4094bd9aedc1dfaa590013d2024-03-25T13:06:01ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422023-01-0134546246710.4103/1319-2442.397210Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 MutationNimisha DangeKiran P SatheAlpana KondekarVishal SawantCongenital nephrotic syndrome (NS) is characterized by early-onset heavy proteinuria. Most cases of congenital NS are associated with genetic mutations in the podocyte proteins. The causal relationship of perinatal infections with congenital NS has not yet been proven. Inadequate response to the treatment of such infections should prompt us to conduct genetic testing for congenital NS. The heavy proteinuria associated with congenital NS is usually difficult to control with conventional treatment. It often results in progressive kidney disease with a high risk of mortality in early life. Here, we describe an infant who developed congenital NS and was found to have a coexisting Cytomegalovirus infection and an underlying NPSH1 mutation. Proteinuria did not respond to a standard dose of enalapril. A supramaximal dose of enalapril was tried and was effective and safe in controlling the proteinuria. It was associated with improved growth, complete resolution of edema, normal serum albumin, and normal renal function beyond 2 years of age.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2023;volume=34;issue=5;spage=462;epage=467;aulast= |
spellingShingle | Nimisha Dange Kiran P Sathe Alpana Kondekar Vishal Sawant Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation Saudi Journal of Kidney Diseases and Transplantation |
title | Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation |
title_full | Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation |
title_fullStr | Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation |
title_full_unstemmed | Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation |
title_short | Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation |
title_sort | effectiveness of supramaximal angiotensin converting enzyme inhibition in controlling proteinuria in congenital nephrotic syndrome with cytomegalovirus infection and an nphs1 mutation |
url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2023;volume=34;issue=5;spage=462;epage=467;aulast= |
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