Optimizing ACE-Inhibitor Therapy for Chronic Kidney Disease

In this issue of the Journal, Hou and colleagues1 present data indicating that the use of benazepril, an angiotensin-converting–enzyme (ACE) inhibitor, is feasible and beneficial in patients with advanced chronic kidney disease, a point that has been much debated. This clinical trial in China, which confirms pilot data from the same group,2 provides some clarity, demonstrating that ACE inhibitors can be administered in generous doses, even in patients with stage 4 chronic kidney disease, as defined by a glomerular filtration rate (GFR) of 15 to 29 ml per minute per 1.73 m2 and a serum creatinine level of approximately 3.0 . . .