ACE Inhibitors and ARBs in Chronic Kidney Disease: A Systematic Review of Randomized Controlled Trials on Albuminuria Reduction, eGFR Decline, and Safety

This article highlights the favorable renal outcomes achieved through optimized renin-angiotensin-aldosterone system (RAAS) blockade in an adult patient with chronic kidney disease (CKD) and significant proteinuria. Sustained therapy led to a marked reduction in albuminuria and stabilization of kidney function over the follow-up period, without clinically significant hyperkalemia or other adverse effects. The observation aligns with the antiproteinuric and renoprotective effects consistently reported in randomized controlled trials, while also underscoring the importance of individualized treatment adjustments to balance efficacy with safety. The clinical course supports the biological rationale that RAAS inhibition reduces intraglomerular pressure and mitigates ongoing renal injury, suggesting its continued relevance as a cornerstone in CKD management. This further emphasizes that optimal dosing, careful monitoring of electrolytes, and attention to comorbidities are key to maximizing therapeutic benefit in real-world practice, and it calls for future research to refine patient selection and long-term outcome strategies.