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AAP Grand Rounds 2:63-64 (1999)
© 1999 American Academy of Pediatrics

NEPHROLOGY

ACE Inhibitors Effective in Patients with Chronic Nephropathies

Source: Ruggenenti P, Perna A, Gherardi G, et al. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet. 1999;354;359–364.

The first 20% of the full text of this article appears below.

This is a report on the second phase of the Ramipril Efficacy in Nephropathy (REIN) study in which Italian patients (18–70 years) with chronic nephropathies and proteinuria (>1 gram but <3grams/day) were randomized to receive either ramipril, an ACE inhibitor, or placebo. ACE inhibitors have been shown to slow the progressive loss of renal function in diabetic nephropathy,1 while an earlier report on phase 1 of the REIN study demonstrated that renal function was stabilized in patients with >3grams/day of proteinuria.2 The present study was designed to see if an ACE inhibitor would be of benefit for patients with lesser degrees of proteinuria.

One hundred and eighty-six patients were randomized in a double blind manner to receive ramipril (n=99) or a placebo (n=87). Monthly for the first 3 months and then every 6 months thereafter, a 24-hour protein measurement, GFR, serum creatinine, blood urea nitrogen, and serum electrolytes were determined on each patient. After 27 months, the code . . . [Full Text of this Article]

Robert J. Cunningham, III, MD, FAAP
Nephrology, Cleveland Clinic, Cleveland, OH