What question did this study set out to answer?

To review the experimental rationale and clinical evidence for using angiotensin converting enzyme (ACE) inhibitors to manage hypertension and progressive renal insufficiency.

September 15, 1989Annals of Internal Medicine

Angiotensin Converting Enzyme Inhibitors and Progressive Renal Insufficiency

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Why the study?

Do ACE inhibitors reduce proteinuria and the progression of renal disease in hypertensive patients with renal insufficiency?

Population

Hypertensive patients with diabetic and nondiabetic renal disease, as well as experimental models of…

Comparison

Angiotensin converting enzyme (ACE) inhibitors vs Other antihypertensive regimens or standard care

Design

Review

Authors

WKW. F. Keane

Discussion

Member takes

Overview

May support ACE inhibitor use for BP and proteinuria control in renal disease; leaves open long-term progression effects pending RCTs.

Key Points

To review the experimental rationale and clinical evidence for using angiotensin converting enzyme (ACE) inhibitors to manage hypertension and progressive renal insufficiency.
Literature and bibliographic hand searches were conducted to identify experimental and clinical studies published between January 1977 and November 1988.
Evaluated animal studies of glomerular function, clinical series of hypertensive patients with diabetic and nondiabetic renal disease, and reported adverse events.
ACE inhibitors effectively lower systemic blood pressure and reduce proteinuria in most diabetic and nondiabetic patients without causing dramatic changes in glomerular filtration rate or renal blood flow.
Documented adverse reactions include hyperkalemia, transient functional declines, and reversible acute renal failure, particularly in patients with bilateral renal insufficiency or low cardiac output.
No long-term controlled trials have established whether ACE inhibitors halt or slow the progression rate of nondiabetic renal disease.

Structured PICO

Do ACE inhibitors reduce proteinuria and the progression of renal disease in hypertensive patients with renal insufficiency?

Population

Hypertensive patients with diabetic and nondiabetic renal disease, as well as experimental models of glomerular injury.

Intervention

Angiotensin converting enzyme (ACE) inhibitors

Comparator

Other antihypertensive regimens or standard care (as reviewed across various studies)

Outcome

Glomerular function, systemic blood pressure, proteinuria, and progression rate of renal diseasesurrogate

This early review highlights that ACE inhibitors effectively reduce blood pressure and proteinuria in patients with renal insufficiency, while noting the need for long-term trials to prove their efficacy in preventing renal disease progression.

Limitations

No long-term controlled study on the effect of ACE inhibitors on the progression rate of nondiabetic renal disease has been completed

Cite This Study

W. F. Keane (1989) studied this question.

synapsesocial.com/papers/6a7cc9ebb7ca9b673b7cd8f7 https://doi.org/10.7326/0003-4819-111-6-503

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September 15, 1989Annals of Internal Medicine

Angiotensin Converting Enzyme Inhibitors and Progressive Renal Insufficiency

View Full Paper

Ask AI

Bookmark

Why the study?

Do ACE inhibitors reduce proteinuria and the progression of renal disease in hypertensive patients with renal insufficiency?

Population

Hypertensive patients with diabetic and nondiabetic renal disease, as well as experimental models of…

Comparison

Angiotensin converting enzyme (ACE) inhibitors vs Other antihypertensive regimens or standard care

Design

Review

Authors

WKW. F. Keane

Discussion

Member takes

Overview

May support ACE inhibitor use for BP and proteinuria control in renal disease; leaves open long-term progression effects pending RCTs.

Key Points

To review the experimental rationale and clinical evidence for using angiotensin converting enzyme (ACE) inhibitors to manage hypertension and progressive renal insufficiency.
Literature and bibliographic hand searches were conducted to identify experimental and clinical studies published between January 1977 and November 1988.
Evaluated animal studies of glomerular function, clinical series of hypertensive patients with diabetic and nondiabetic renal disease, and reported adverse events.
ACE inhibitors effectively lower systemic blood pressure and reduce proteinuria in most diabetic and nondiabetic patients without causing dramatic changes in glomerular filtration rate or renal blood flow.
Documented adverse reactions include hyperkalemia, transient functional declines, and reversible acute renal failure, particularly in patients with bilateral renal insufficiency or low cardiac output.
No long-term controlled trials have established whether ACE inhibitors halt or slow the progression rate of nondiabetic renal disease.

Structured PICO

Do ACE inhibitors reduce proteinuria and the progression of renal disease in hypertensive patients with renal insufficiency?

Population

Hypertensive patients with diabetic and nondiabetic renal disease, as well as experimental models of glomerular injury.

Intervention

Angiotensin converting enzyme (ACE) inhibitors

Comparator

Other antihypertensive regimens or standard care (as reviewed across various studies)

Outcome

Glomerular function, systemic blood pressure, proteinuria, and progression rate of renal diseasesurrogate

Limitations

No long-term controlled study on the effect of ACE inhibitors on the progression rate of nondiabetic renal disease has been completed

Cite This Study

W. F. Keane (1989) studied this question.

synapsesocial.com/papers/6a7cc9ebb7ca9b673b7cd8f7 https://doi.org/10.7326/0003-4819-111-6-503

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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