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Elaine Ku, MD; Jeanie Park, MD; Jay Vidhun, MD; Vito Campese, MD

Arch Intern Med. 2009;169(11):1015-1018.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Chronic kidney disease (CKD) is increasing in prevalence in the United States. Therapies that can retard the progression of CKD are needed to prevent the morbidity and mortality associated with reduced renal function. Although multiple studies published in the past 10 years have supported the combination use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to decrease proteinuria and delay disease progression, it is our position that combinations of ACE inhibitors and ARBs should be used with great caution in patients with CKD. We do not dispute that ACE inhibitors or ARBs used as monotherapy can decrease proteinuria and retard progression of renal disease. However, in combination, the risks of adverse effects, including hyperkalemia, hypotension, and worsening renal failure, could outweigh the purported benefits of dual blockade. Until more studies are conducted on the safety of . . . [Full Text of this Article]

BACKGROUND

Epidemiology and Prevalence of CKD

Pathophysiologic Characteristics and Rationale Behind Dual Blockade

COMMENT
The Evolution of Dual Blockade: The COOPERATE Trial

Meta-analysis on Dual Blockade

The ONTARGET Trial

CONCLUSIONS

AUTHOR INFORMATION


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The Case for Dual Renin-Angiotensin System Inhibition
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