In chronic nephropathies, ACE inhibitors have renoprotective effect.

REIN-2 Study Group assessed the effect of intensified versus conventional blood-pressure control on progression to end-stage renal disease.

The patients with non-diabetic proteinuric nephropathies, receiving background treatment with the ACE inhibitor Ramipril ( 2·5-5 mg/day ), were randomly assigned either conventional ( diastolic < 90 mm Hg ) or intensified ( systolic/diastolic < 130/80 mm Hg ) blood-pressure control.

The patients in intensified blood-pressure control group received add-on therapy with the Felodipine (5-10 mg/day), a calcium-channel blocker.

The primary end point was time to end-stage renal disease.

The median follow-up was 19 months.

The 23 percent of patients in intensified blood-pressure control group and the 20 percent assigned to conventional control progressed to end-stage renal disease ( hazard ratio, HR: 1·00 ).

The results of study showed that there was no benefit of adding a calcium-channel blocker to Ace inhibitor in the patients with non-diabetic proteinuric nephropathies.

Source: Lancet, 2005


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