Why the study?
Does targeting the renin-angiotensin system with ACE inhibitors or ARBs reduce the progression of renal disease and cardiovascular morbidity/mortality in patients with renal disease?
Does targeting the renin-angiotensin system with ACE inhibitors or ARBs reduce the progression of renal disease and cardiovascular morbidity/mortality in patients with renal disease?
This review summarizes the evidence for using ACE inhibitors and ARBs to slow renal disease progression and reduce cardiovascular risk in patients with nephropathy.
Supports ACEi/ARB use in nephropathy; leaves open optimal dosing and head-to-head comparisons in advanced CKD.
The rationale for use of angiotensin-converting enzyme (ACE) inhibitors in patients with proteinuria or established renal impairment is in general twofold—first, to slow the progression of renal disease, by reducing blood pressure (BP) and proteinuria or by other renoprotective mechanisms; second, to lessen the risk of cardiovascular morbidity and mortality associated with chronic renal disease and with one of its leading causes, diabetes. This review highlights the evidence for and against targeting the renin-angiotensin system in the treatment of patients with different types of nephropathy. Findings from the major studies are summarized in Table 1. Table 1 Summary of major trials investigating renoprotective effect of ACE inhibitors and ARBs
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Devonald et al. (2002) studied this question.
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