Efficacy and Safety of Benazepril for Advanced Chronic Renal Insufficiency

• Published in: The New England journal of medicine Vol. 354; no. 2; pp. 131 - 140
• Main Authors: Hou, Fan Fan, Zhang, Xun, Zhang, Wei Ru, Zhang, Guo Hua, Xie, Di, Chen, Ping Yan, Jiang, Jian Ping, Liang, Min, Wang, Guo Bao, Liu, Zheng Rong, Geng, Ren Wen
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12.01.2006
• Subjects: Adult; Aged; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Angiotensin-Converting Enzyme Inhibitors - adverse effects; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Antihypertensive Agents - therapeutic use; Benzazepines - administration & dosage; Benzazepines - adverse effects; Benzazepines - therapeutic use; Biological and medical sciences; Blood Pressure - drug effects; China; Creatinine - blood; Diabetes; Disease Progression; Double-Blind Method; Female; General aspects; Heart attacks; Humans; Kidney diseases; Kidney Failure, Chronic - prevention & control; Male; Medical sciences; Medical treatment; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Proteinuria - drug therapy; Renal failure; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - mortality; China; Kidney disease; Urinary system disease; Enzyme; Toxicity; Enzyme inhibitor; Medicine; Peptidases; Chronic; Peptidyl-dipeptidase A; Renal failure; Hydrolases; Peptidyl-dipeptidases; Antihypertensive agent; Benazepril; Advanced stage; Safety; ACE inhibitor
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa053107

Angiotensin-converting–enzyme (ACE) inhibitors provide renal protection in patients with mild-to-moderate renal insufficiency, slowing progression. However, the efficacy and safety of this class of medications in patients with advanced renal insufficiency are less clear. The results of this randomized, double-blind study indicate that benazepril, an ACE inhibitor, confers substantial renal benefits in patients without diabetes who have advanced renal insufficiency. The results of this randomized, double-blind study indicate that benazepril, an ACE inhibitor, confers substantial renal benefits in patients without diabetes who have advanced renal insufficiency. Angiotensin-converting–enzyme (ACE) inhibitors slow the progression of chronic kidney disease in the presence or absence of diabetes, particularly in patients with mild-to-moderate renal insufficiency, as reflected by a serum creatinine level of 1.5 to 3.0 mg per deciliter (133 to 265 μmol per liter). 1 – 3 Data, however, have been limited to patients with serum creatinine levels of 3.0 mg per deciliter or less. Many physicians are reluctant to use ACE inhibitors in patients with advanced renal insufficiency because of concern that serum creatinine or potassium levels will rise. 4 , 5 Many infer that the unique benefits of these drugs in patients . . .