Angiotensin-converting enzyme inhibitor therapy for non-diabetic progressive renal disease

Piero Ruggenenti, Giuseppe Remuzzi

Research output: Contribution to journalArticlepeer-review


Chronic renal disease evolves to end-stage renal failure through events, including enhanced intraglomerular pressure and plasma protein ultrafiltration, mediated at least in part by angiotensin II. Angiotensin- converting enzyme inhibitors reduce intracapillary pressure and ameliorate glomerular size-selective function, which may account for their antiproteinuric effect and renoprotective potential. Thus, the Ramipril Efficacy in Nephropathy study found a significant correlation between enhanced urinary protein excretion and faster disease progression in non- diabetic patients with proteinuric chronic renal disease. In proteinuric non- diabetic renal disease at comparable levels of blood pressure control, angiotensin-converting enzyme inhibitors reduce proteinuria and slow disease progression to end-stage renal failure safely and more effectively than non- angiotensin-converting enzyme therapy. On the contrary, most non-proteinuric chronic renal diseases progress slowly and do not benefit specifically from angiotensin-converting enzyme inhibition therapy.

Original languageEnglish
Pages (from-to)489-495
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Issue number5
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine


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