The role of ACE inhibitors in retarding the progression of non diabetic chronic kidney disease by controlling blood pressure and proteinuria.

ABSTRACT

Lowering of blood pressure itself lowers urinary protein excretion rate and slows rate of GFR decline in chronic renal disease. There are data that suggests that ACE inhibitors improve glomerular barrier size selective function in experimental and human renal disease by directly lowering the mean dimensions of large unselective pores. A reduction in urinary protein excretion correlates with improved renal function and survival in non diabetic and diabetic renal disease. The initial reduction in rate of excretion inversely correlates with long term preservation of renal function in patient without diabetes treated with angiotensin converting enzyme inhibitors. In this study of 97 patients, the results showed that antihypertensive regimens of ace inhibitors group were more effective than non ace inhibitor in slowing progression of non diabetic chronic kidney disease. The presence of proteinuria in non diabetic chronic kidney disease is a strong indication for treatment with ace inhibitors. A brief epidemiology and pathophysiology is also discussed to understand the role of hypertension and proteinuria in chronic kidney disease.