Dual therapy with an ACE inhibitor and ARB in pediatric patients requires close surveillance of renal function and blood pressure due to the risk of acute renal failure and hypotension.
May warrant close renal and BP monitoring with pediatric dual ACEI/ARB; leaves open need for systematic safety data.
The use of combined therapy with an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II receptor blocker (ARB) for treatment of proteinuria has been gaining support. Limited data are available regarding this treatment in the pediatric population. This report describes a case of acute compromise of renal function associated with hypotension in a 7-year-old boy treated with the ACE inhibitor lisinopril and the ARB losartan. It emphasizes the need for close surveillance of renal function and blood pressure during such therapy even in patients with relative preservation of renal function. Further investigation into the utility and safety of dual therapy with an ACE inhibitor plus an ARB in pediatric patients is warranted.
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Coral D. Hanevold (2006) studied this question.
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