Abstract

Chronic kidney disease (CKD) is a growing concern in children, leading to significant health complications. While angiotensin-converting enzyme (ACE) inhibitors are used in adults with CKD to slow disease progression, their effectiveness in pediatric patients remains unclear. This systematic review aimed to evaluate the existing research on the efficacy and safety of ACE inhibitors in delaying the progression of CKD in children. A systematic search of electronic databases like PubMed, MEDLINE, Science Direct, and Scopus was conducted. Two independent reviewers screened and extracted data from eligible studies. Six studies including 519 participants in total, of which 209 (40%) were females, were included in the study data. The follow-up duration ranged from 6 months to 7.75 years. ACE inhibitors decreased the albumin excretion rate in daily urine and the albumin creatinine ratio in daily urine dropped with renoprotective therapy. Management with ACE inhibitors maintained graft function in children with chronic allograft dysfunction, with enhancement of creatinine clearance in children undergoing renal transplantation. To this day, ACEIs represent the greatest known means of slowing the advancement of pediatric nephropathy and chronic non-diabetic renal disorders. Prospective comparison research and trials of combination therapy with ACEI and angiotensin receptor blocker should be promoted in children. A multicenter trial would be necessary due to the minimal number of patients.

Key words: Pediatric, chronic kidney disease (CKD), End-stage renal disease (ESRD), ACE inhibitors, glomerular filtration rate (GFR)