In Chronic Nephropathies Prolonged ACE Inhibition Can Induce Remission Dynamics of Time-Dependent Changes in GFR

摘要: Abstract . The Ramipril Efficacy in Nephropathy Core and Follow-Up Study found that ≥36 mo of continued ramipril therapy decreased substantially the risk end-stage renal failure (ESRF) patients with chronic nephropathies a urinary protein excretion rate ≥3 g/24 h. This study investigates time-dependent changes GFR these control subjects who were randomized to conventional during period switched study. Analyses included 150 (continued ramipril: n = 74; 76) had at least three measurements (including baseline) whole observation subgroup 43 26; 17) six measurements, including on (1.25 5 mg/d) targeted achieving diastolic BP below 90 mmHg. main efficacy variables ESRF (need for dialysis). Analysis was by intention treat. Throughout study, mean ± SEM decline (ΔGFR) significantly lower compared those (0.51 0.09 versus 0.76 0.10 ml/min per 1.73 m 2 mo, P mo): 0.16 0.12 (at 18 mo) 0.05 60 mo). about 10-fold slower REIN individual slopes end follow-up, 10 26 positive ΔGFR another an improvement while therapy. improved parallel significant reduction proteinuria. Changes ( 0.0001) proteinuria 0.04) different two groups. Baseline characteristics systolic 24-h urine urea sodium comparable. present results offer evidence nephropathies, tendency time can be effectively halted, even remarkably severe disease.