Ruggenenti P, Perna A, Mosconi L, Matalone M, Gaspari F,
Garini G, Salvadori M, Zoccali C, Scolari
The angiotensin-converting-enzyme (ACE) inhibitor ramipril
slows the rate of GFR decline and the progression to end stage
renal failure (ESRF) in proteinuric, non-diabetic chronic renal
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol
(Sep) 8:147A 1997
The ramipril efficacy in nephropathy (REIN) trial is a double-
blind randomized placebo controlled trial to determine whether at
comparable blood pressure control, the ACE inhibitor ramipril
(1.25-5 mg/d) can slow GFR decline in non-diabetic renal disease.
352 patients were stratified for baseline proteinuria (Stratum 1:
1-3 g/24h, n=186; Stratum 2: > 3 g/24h, n=166). Target DBP was
<
90 mm Hg. In Stratum 2, decline in GFR was 0.53 ml/min/mo in the
ramipril vs. 0.88 in the placebo group, p=0.03, despite equal BP
control (Stratum 1 data has not yet been analyzed). Percent
reduction in proteinuria was inversely correlated with decline in
GFR and predicted a lower risk of ESRD.
Comment: These results give further evidence that
ACE inhibitors
are renoprotective in patients non-diabetic as well as diabetic
glomerular disease. It is not clear as to what percent of
patients were hypertensive.
(David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area :
Progression
H: Drug therapy :
ACE inhibitors