BACKGROUND: It is not known whether withdrawal of angiotensin-converting enzyme inhibitors (ACEIs) in children with advanced chronic kidney disease (CKD) is beneficial similar to adults. We report a case series of children with advanced CKD whose ACEIs were stopped. METHODS: In the last 5 years, we stopped ACEIs in seven consecutive children on ACEI therapy with rapidly declining CKD stage 4-5. The median age was 12.5 years (range 6.8-17.6); the median estimated glomerular filtration rate (eGFR) at stopping ACEIs was 12.5 ml/min/1.73 m2 (range 8.8-19.9). RESULTS: Six to twelve months after stopping ACEIs, the eGFR increased in five children (71%). The median absolute increase of eGFR was 5.0 ml/min/1.73 m2 (range -2.3 to +20.0) and relative increase of eGFR was 30% (range -34 to +99). The median follow-up after stopping ACEIs was 2.7 (range 0.5-5.0) years, either until the start of dialysis (n = 5) or until the last follow-up without dialysis (n = 2). CONCLUSIONS: This case series showed that withdrawal of ACEIs in children with CKD stage 4-5 and rapidly declining kidney function may lead to an increase in eGFR.

Department of Pediatrics 2nd Medical Faculty Charles University Prague Prague Czechia

Department of Pediatrics University Hospital Ostrava Ostrava Czechia

Faculty of Mediciny University of Ostrava Ostrava Czechia

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