Clinical efficacy of medicinal treatment in 15 children with Dent disease / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the drug effect of children with Dent disease who received therapy of po-tassium citrate and thiazide diuretics and angiotensin -converting enzyme inhibitors(ACEI),and to provide the refe-rence for the clinical treatment.Methods Dent disease patient who were followed -up in Bayi Children′s Hospital Af-filiated to Beijing Military Region General Hospital during the period of July 2006 and March 201 4 were selected.The patients were administered a therapy of potassium citrate associated with thiazide diuretics and ACEI according to the level of proteinuria and calciuria and serum potassium.The underlying changes before and after the treatment were com-pared and analyzed.Results In 1 5 children with Dent disease,they were all male cases,onset age ranged from 3 months to 1 1 years old[(2.62 ±3.1 1 )years old],and the disease duration ranged from 0.50 to 9.50 years old [(2.81 ±2.34)years].The patients were followed up for 0.50 to 7.50 years[(3.61 ±2.62)years].There was a sig-nificantly statistical difference in calcium/creatinine and daily Ca -creat ratio in contrast to before treatment[(0.41 ± 0.1 9)mg/mg vs(0.26 ±0.1 2)mg/mg,t =2.603,P =0.021 ;(6.76 ±2.0)mg/kg vs (4.34 ±1 .97)mg/kg,t =5.265,P =0.000],there was no significantly statistical difference in 24 -hour urinary protein quantity in contrast to before treatment[(0.96 ±0.62)g/24 h vs (0.87 ±0.44)g/24 h,t =1 .01 6,P =0.327].One case with kidney stone and 5 cases with nephrocalcinosis had a negative result of renal ultrasound after treatment.Conclusions Treatment of potassium citrate combination with thiazide diuretics and ACEI can significantly decrease urinary calcium excretion, make a disappearance of kidney stone and nephrocalcinosi,and it may have a role in protecting renal function.Treat-ment of benazepril can not significantly decrease the proteinuria and has no substantial improvement in low molecular weight protein urine.