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Combined treatment with angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers to prevent end-stage kidney disease in patients who do not have diabetes

Giovanni FM Strippoli and Craig C Jonathan
Med J Aust 2004; 181 (8): . || doi: 10.5694/j.1326-5377.2004.tb06375.x
Published online: 18 October 2004

In patients without diabetes, but with impaired renal function and proteinuria, does combination treatment with the angiotensin-converting enzyme (ACE) inhibitor trandolapril and the angiotensin-receptor blocker (ARB) losartan prevent deterioration of renal function more effectively than treatment with either agent used alone?


  • 1 Centre for Kidney Research, Cochrane Renal Group, NHMRC Centre of Clinical Research Excellence in Renal Medicine, The Children’s Hospital at Westmead, University of Sydney, Sydney, NSW.
  • 2 Centre for Kidney Research, NHMRC Centre of Clinical Research Excellence in Renal Medicine, Cochrane Renal Group, School of Public Health, University of Sydney, Australia, Sydney, NSW.


Correspondence: 

Competing interests:

None identified.

  • 1. Anderson S, Rennke HG, Brenner BM. Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat. J Clin Invest 1986; 77: 1993-2000.
  • 2. The GISEN group (Gruppo Italiano di Studi Epidemiologici in Nefrologia). Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. Lancet 1997; 349: 1857-1863.
  • 3. 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.
  • 4. Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency; the Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency study group. N Engl J Med 1996; 334: 939-945.
  • 5. Locatelli F, Carbarns IRI, Maschio G, et al. Long-term progression of chronic renal insufficiency in the AIPRI Extension Study. Kidney Int 1997; 52 (Suppl 63): S63-S66.
  • 6. Jafar TH, Schmit CH, Landa M, 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.
  • 7. Nakao N, Yoshimura A, Morita H, et al. Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomized controlled trial. Lancet 2003; 361: 117-124.
  • 8. Gardman AH, Arcuri KE, Goldberg AI, et al. A randomized, placebo-controlled, double-blind, parallel study of various doses of losartan potassium compared with enalapril maleate in patients with essential hypertension. Hypertension 1995; 25: 1345-1350.
  • 9. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ 2003; 326: 219.
  • 10. McMurray JJ, Ostergren J, Swedberg K, et al for the CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 2003; 362: 767-771.
  • 11. McKelvie RS, Yusuf S, Pericak D, et al. Comparison of candesartan, enalapril, and their combination in congestive heart failure: randomized evaluation of strategies for left ventricular dysfunction (RESOLVD) pilot study. The RESOLVD Pilot Study Investigators. Circulation 1999; 100: 1032-1034.
  • 12. Pfeffer MA, McMurray JJ, Velazquez EJ, et al. Valsartan, captopril or both in myocardial infarction complicated by heart failure, left ventricular dysfunction or both. New Engl J Med 2003; 349: 1893-1906.

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