Use of ACE inhibitors in diabetic and nondiabetic patients with renal disease

Clinical studies have demonstrated the benefit of angiotensin-converting enzyme (ACE) inhibitors in retarding the progression of renal disease, stabilizing or reducing urinary albumin excretion, and improving the glomerular filtration rate beyond that attributable to their antihypertensive effects. Based on their effectiveness in reducing the risks of diabetic nephropathy, ACE inhibitors are recommended as first-line therapy for all hypertensive diabetic patients with microalbuminuria or more advanced stages of renal nephropathy. They are similarly recommended for nondiabetic patients with renal disease based on their effectiveness in slowing the progression of renal dysfunction in patients with various forms of renal disease.