Pediatric Nephrology

, Volume 21, Issue 10, pp 1480–1482 | Cite as

Candesartan cilexetil in children with hypertension or proteinuria: preliminary data

  • ChIld Project
  • Giacomo D. Simonetti
  • Rodo O. von Vigier
  • Martin Konrad
  • Mattia Rizzi
  • Emilio Fossali
  • Mario G. BianchettiEmail author
Brief Report


The angiotensin II receptor blockers irbesartan and losartan effectively reduce blood pressure and proteinuria in childhood. We were impressed by the neutral taste and the small size of the candesartan cilexetil tablets. This angiotensin II receptor blocker was used during 4 months in 17 pediatric patients (aged 0.5–16, median 4.5 years) with chronic arterial hypertension (n=6), overt proteinuria (n=2), or both (n=9). The initial candesartan dose of 0.23 (0.16–0.28) mg/kg body weight once daily (median and interquartile ranged) was doubled in ten patients [final dose 0.35 (0.22–0.47) mg/kg body weight]. No adverse clinical experiences were noted on candesartan. Candesartan increased plasma potassium by 0.3 (0.0–0.8) mmol/l (P<0.01). In children with arterial hypertension, blood pressure decreased by 9 (3–13)/9 (3–18) mmHg (P<0.01); in those with overt proteinuria the urinary albumin/creatinine ratio decreased by 279 (33–652) mg/mmol (P<0.05). In conclusion, in children candesartan reduces blood pressure and proteinuria with an excellent short-term tolerability profile.


Candesartan Child Hypertension Proteinuria 



We acknowledge the support of the Associazione Bambino Nefropatico and of the Fondazione Ettore e Valeria Rossi.


  1. 1.
    Hilgers KF, Dotsch J, Rascher W, Mann JF (2004) Treatment strategies in patients with chronic renal disease: ACE inhibitors, angiotensin receptor antagonists, or both? Pediatr Nephrol 19:956–961CrossRefGoogle Scholar
  2. 2.
    Cheung BM, Cheung GT, Lauder IJ, Lau CP, Kumana CR (2006) Meta-analysis of large outcome trials of angiotensin receptor blockers in hypertension. J Hum Hypertens 20:37–43CrossRefGoogle Scholar
  3. 3.
    Dominiak P, Häuser W (2003) Äquivalenzdosen der in Deutschland verfügbaren AT1-Rezeptor-Antagonisten. Dtsch Med Wochenschr 128:2315–2318 (Erratum in: Dtsch Med Wochenschr 129:646)CrossRefGoogle Scholar
  4. 4.
    von Vigier RO, Zberg PM, Teuffel O, Bianchetti MG (2000) Preliminary experience with the angiotensin II receptor antagonist irbesartan in chronic kidney disease. Eur J Pediatr 159:590–593CrossRefGoogle Scholar
  5. 5.
    Franscini LM, von Vigier RO, Pfister R, Casaulta-Aebischer C, Fossali E, Bianchetti MG (2002) Effectiveness and safety of the angiotensin II antagonist irbesartan in children with chronic kidney diseases. Am J Hypertens 15:1057–1063CrossRefGoogle Scholar
  6. 6.
    Gartenmann AC, Fossali E, von Vigier RO, Simonetti GD, Schmidtko J, Edefonti A, Bianchetti MG (2003) Better renoprotective effect of angiotensin II antagonist compared to dihydropyridine calcium channel blocker in childhood. Kidney Int 64:1450–1454CrossRefGoogle Scholar
  7. 7.
    Ellis D, Vats A, Moritz ML, Reitz S, Grosso MJ, Janosky JE (2003) Long-term antiproteinuric and renoprotective efficacy and safety of losartan in children with proteinuria. J Pediatr 144:834–835Google Scholar
  8. 8.
    Ellis D, Moritz ML, Vats A, Janosky JE (2004) Antihypertensive and renoprotective efficacy and safety of losartan. A long-term study in children with renal disorders. Am J Hypertens 17:928–935PubMedGoogle Scholar
  9. 9.
    Shahinfar S, Cano F, Soffer BA, Ahmed T, Santoro EP, Zhang Z, Gleim G, Miller K, Vogt B, Blumer J, Briazgounov I (2005) A double-blind, dose-response study of losartan in hypertensive children. Am J Hypertens 18:183–190CrossRefGoogle Scholar
  10. 10.
    Nahata MC (1999) Lack of pediatric drug formulations. Pediatrics 104:607–609PubMedGoogle Scholar
  11. 11.
    Nevins TE (2005) “Why do they do that?” The compliance conundrum. Pediatr Nephrol 20:845–848CrossRefGoogle Scholar
  12. 12.
    National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576CrossRefGoogle Scholar
  13. 13.
    Palmer BF (2003) Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: what to do if the serum creatinine and/or serum potassium concentration rises. Nephrol Dial Transplant 18:1973–1975CrossRefGoogle Scholar
  14. 14.
    Tóth-Heyn P, Drukker A, Guignard JP (2000) The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy. Pediatr Nephrol 14:227–239CrossRefGoogle Scholar
  15. 15.
    Alwan S, Polifka JE, Friedman JM (2005) Angiotensin II receptor antagonist treatment during pregnancy. Birth Defects Res A Clin Mol Teratol 73:123–123CrossRefGoogle Scholar

Copyright information

© IPNA 2006

Authors and Affiliations

  • ChIld Project
  • Giacomo D. Simonetti
    • 1
  • Rodo O. von Vigier
    • 1
  • Martin Konrad
    • 1
  • Mattia Rizzi
    • 1
  • Emilio Fossali
    • 2
  • Mario G. Bianchetti
    • 3
    • 4
    Email author
  1. 1.Department of PediatricsInselspitalBernSwitzerland
  2. 2.De Marchi Children’s HospitalMilanItaly
  3. 3.Ospedale San Giovanni and Ospedale della BeataVergine MendrisioSwitzerland
  4. 4.San Giovanni HospitalBellinzonaSwitzerland

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