Dosing of ACE Inhibitors to Reduce Proteinuria

Angiotensin-converting-enzyme (ACE) inhibitors are used both to lower blood pressure and to reduce proteinuria in certain patients with renal disease. However, the extent to which . . .

Angiotensin-converting-enzyme (ACE) inhibitors are used both to lower blood pressure and to reduce proteinuria in certain patients with renal disease. However, the extent to which the antiproteinuric effect parallels the antihypertensive effect is unclear.

In this industry-sponsored Austrian study, researchers gave the ACE inhibitor spirapril (not available in the U.S.) to 23 patients with an assortment of proteinuric nondiabetic renal diseases; at baseline, median urine protein was 2.56 g daily, and median serum creatinine was 1.43 mg/dL. The dose of spirapril was titrated upward to reduce BP until an additional dose increase did not lower BP further. At the spirapril dose that maximized BP reduction, median daily proteinuria decreased to 1…

Reviewing Author

Allan S. Brett, MD