January 12, 2006 - Doctors in China report in the New England Journal of Medicine (NEJM) that use of higher doses of ACE inhibitors on top of standard antihypertensive treatment may slow the progression of chronic renal insufficiency in patients without diabetes. Article from WebMD.

Efficacy and Safety of Benazepril for Advanced Chronic Renal Insufficiency - abstract from NEJM.

December 9, 2005 - In stark contrast to existing dogma, researchers from University College in London have found that angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-II receptor blockers (ARB) are no better than other drugs used to lower blood pressure in preventing diabetic kidney disease. Researchers also indicate that it is unclear if the drugs are more effective in non-diabetic kidney disease. Summary from Ivanhoe.com.

"Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes" - abstract from The Lancet (registration required, but free)

"The first-line drug choices to treat high blood pressure in patients with kidney disease may not be the best option, according to new research. The investigators conclude: �treatment decisions for hypertension in renal disease should be based on the blood-pressure-lowering effect, comparative tolerability, and cost of antihypertensive treatment."

September 23, 2005 - Two interesting news stories about ACE inhibitors and kidney disease:

GenoMed, Inc.'s CEO and Chief Medical Officer David Moskowitz charged that news of its ability to prevent up to 90% of chronic kidney disease has been suppressed for the past three years. (Dr. Moskowitz has long associated the ACE gene with numerous disease and aging processes.) GenoMed press release via PR Newswire.

Hmmmmmmmm..... But what about.....

The US Food and Drug Adminstration (FDA) approved King Pharmaceuticals, Inc. Altace (ramipril) for the treatment of chronic kidney disease in a filing for the Company's supplemental new drug application that seeks a new indication for the drug. (Ramipril is an ACE inhibitor.) Press release via Yahoo. (link is no longer available)

Two related news briefs from the National Institute of Diabetes & Digestive & Kidney Diseases:

"Drugs Found to Protect the Kidneys" - October 13, 2000

"Continuation of AASK Cohort Study" - last updated 2/17/2004

"Effect of Ramipril vs Amlodipine on Renal Outcomes in Hypertensive Nephrosclerosis" - abstract from the Journal of the American Medical Association (June 6, 2001)

Although both drugs were equally effective at controlling blood pressure, patients who took the ACE inhibitor had a 48 percent lower risk of death, dialysis, or dangerous drops in kidney function over three years.

"ACE Inhibitors to Prevent End-Stage Renal Disease: When to Start and Why Possibly Never to Stop: A Post Hoc Analysis of the REIN Trial Results" - abstract from the Journal of the American Society of Nephrology (December 2001)

"Thus, disease progression and response to ACE inhibition do not depend on severity of renal insufficiency. The risk of ESRD and the absolute number of events saved by ACE inhibition is highest in patients with the lowest GFR. However, renoprotection is maximized when ACE inhibition is started earlier and when long-lasting treatment may result in GFR stabilization and definitive prevention of ESRD."

July 19, 2005 - Nothing in life is free, the old saying goes. But maybe some things should be, a new study shows. Specifically, a group of medicines called angiotensin converting enzyme (ACE) inhibitors should be available at no cost to people over age 65 who have diabetes, to prevent costly heart and kidney problems. Press release from the University of Michigan Health System via NewsWise.

The study has been published in the current issue of the Annals of Internal Medicine (AIM):

"Cost-Effectiveness of Full Medicare Coverage of Angiotensin-Converting Enzyme Inhibitors for Beneficiaries with Diabetes" - abstract from AIM

Says lead author Allison Rosen, M.D., M.P.H., Sc.D., "Patients' out-of-pocket costs such as co-pays are a blunt instrument designed to keep patients from over-using medications, but they create barriers to the use of essential and non-essential medications alike. Our analysis shows that removing all patient costs for diabetes patients taking ACE inhibitors could save Medicare both lives and money."

The current issue of Nephrology Incite contains an interview with Dr. David Moskowitz+, who has long associated the ACE gene with numerous disease and aging processes.

[Page reviewed on 01/20/06.]