The Effect of Angiotensin-Converting Enzyme Inhibitors on the Progression of Nondiabetic Renal Disease: A Pooled Analysis of Individual-Patient Data from 11 Randomized, Controlled Trials

Editorials17 July 2001The Effect of Angiotensin-Converting Enzyme Inhibitors on the Progression of Nondiabetic Renal Disease: A Pooled Analysis of Individual-Patient Data from 11 Randomized, Controlled TrialsRobert W. Schrier, MD and Raymond O. Estacio, MDRobert W. Schrier, MDDr. Schrier: University of Colorado Health Sciences Center, Denver, CO 80262Dr. Estacio: Denver Health, Denver, CO 80204 and Raymond O. Estacio, MDDr. Schrier: University of Colorado Health Sciences Center, Denver, CO 80262Dr. Estacio: Denver Health, Denver, CO 80204Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-2-200107170-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An increase in the incidence of end-stage renal disease (ESRD) in most developed countries around the world has been due in part to the increasing incidence of diabetes mellitus worldwide. However, it is clear that at least 50% of the new cases of ESRD are not secondary to diabetes. While the success of renal replacement in patients with ESRD, using either a variety of dialytic approaches or kidney transplantation, is clearly one of the major advances in modern medicine, the ultimate goal must be to prevent the progression to ESRD. In recent years, results from randomized clinical trials have demonstrated ...References1. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med. 1993;329:1456-62. [PMID: 8413456] CrossrefMedlineGoogle Scholar2. . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329:977-86. CrossrefMedlineGoogle Scholar3. . Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352:837-53. CrossrefMedlineGoogle Scholar4. Ravid M, Lang R, Rachmani R, Lishner M. Long-term renoprotective effect of angiotensin-converting enzyme inhibition in non–insulin-dependent diabetes mellitus. A 7-year follow-up study. Arch Intern Med. 1996;156:286-9. [PMID: 8572838] CrossrefMedlineGoogle Scholar5. Mosconi L, Ruggenenti P, Perna A, Mecca G, Remuzzi G. Nitrendipine and enalapril improve albuminuria and glomerular filtration rate in non-insulin dependent diabetes. Kidney Int Suppl. 1996;55:S91-3. [PMID: 8743521] MedlineGoogle Scholar6. Jafar TH, Schmid CH, Landa M, Giatras I, Toto R, Remuzzi G, et al . Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data. Ann Intern Med. 2001;135:73-87. LinkGoogle Scholar7. Kasiske BL, Kalil RS, Ma JZ, Liao M, Keane WF. Effect of antihypertensive therapy on the kidney in patients with diabetes: a meta-regression analysis. Ann Intern Med. 1993;118:129-38. [PMID: 8416309] LinkGoogle Scholar8. Gansevoort RT, Sluiter WJ, Hemmelder MH, de Zeeuw D, de Jong PE. Antiproteinuric effect of blood-pressure-lowering agents: a meta-analysis of comparative trials. Nephrol Dial Transplant. 1995;10:1963-74. [PMID: 8643149] MedlineGoogle Scholar9. Weidmann P, Schneider M, Büohlen L. Therapeutic efficacy of different anti-hypertensive drugs in human diabetic nephropathy: an updated meta-analysis. Nephrol Dial Transplant. 1995;10 Suppl 9 39-45. [PMID: 8643207] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Schrier: University of Colorado Health Sciences Center, Denver, CO 80262Dr. Estacio: Denver Health, Denver, CO 80204Corresponding Author: Robert W. Schrier, MD, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Room 6403, Denver, CO 80262; e-mail, Robert.[email protected]edu.Current Author Addresses: Dr. Schrier: University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Room 6403, Denver, CO 80206.Dr. Estacio: Denver Health c/o Westside Health Center, 1100 Federal Building, Denver, CO 80204. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAngiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease Tazeen H. Jafar , Christopher H. Schmid , Marcia Landa , Ioannis Giatras , Robert Toto , Giuseppe Remuzzi , Giuseppe Maschio , Barry M. Brenner , Annelise Kamper , Pietro Zucchelli , Gavin Becker , Andres Himmelmann , Kym Bannister , Paul Landais , Shahnaz Shahinfar , Paul E. de Jong , Dick de Zeeuw , Joseph Lau , Andrew S. Levey , and Effect of Angiotensin-Converting Enzyme Inhibitors on Progression of Nondiabetic Renal Disease Tazeen H. 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Levey, MD 17 July 2001Volume 135, Issue 2Page: 138-139KeywordsACE inhibitorsAngiotensin converting enzymeBlood pressureEpidermal growth factorExcretionProteinsRenal diseasesRenal failureType 1 diabetesUrine ePublished: 17 July 2001 Issue Published: 17 July 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...