Why the study?
Does combination treatment with an ACE inhibitor and an ARB provide greater renoprotection than either agent alone in patients with chronic kidney disease?
Does combination treatment with an ACE inhibitor and an ARB provide greater renoprotection than either agent alone in patients with chronic kidney disease?
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Combination therapy with ACE inhibitors and ARBs may offer enhanced renoprotection and proteinuria reduction in CKD patients, but requires validation in larger outcome trials.
Chronic kidney disease (CKD) is a major public health problem that has received increasing attention because of the high rate of associated cardiovascular morbidity and mortality. Mounting evidence indicates that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), drugs that inhibit the renin-angiotensin-aldosterone system (RAAS) safely slow down progression of CKD. There is also growing evidence supporting combination treatment of nephropathies with an ACE inhibitor plus an ARB to more completely block the RAAS and provide greater renoprotection than either an ACE inhibitor-based or ARB-based regimen. The National Kidney Foundation suggests that ACE inhibitors and ARBs may be used in combination to reduce proteinuria in patients with kidney disease; however, larger outcomes trials are needed.
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Toto et al. (2007) studied this question.
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