Optimizing ACE-Inhibitor Therapy for Chronic Kidney Disease

Abstract

In this issue of the Journal, Hou and colleagues¹ present data indicating that the use of benazepril, an angiotensin-converting–enzyme (ACE) inhibitor, is feasible and beneficial in patients with advanced chronic kidney disease, a point that has been much debated. This clinical trial in China, which confirms pilot data from the same group,² provides some clarity, demonstrating that ACE inhibitors can be administered in generous doses, even in patients with stage 4 chronic kidney disease, as defined by a glomerular filtration rate (GFR) of 15 to 29 ml per minute per 1.73 m² and a serum creatinine level of approximately 3.0 . . .