Dual Therapy with ACE Inhibitors and Angiotensin II Receptor Blockers in Proteinuric IgA Nephropathy Patients

Experimental evidence supports dual pharmacologic blockade of the renin–angiotensin system with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in proteinuric renal disease. Nonetheless, exaggerated therapeutic benefits are frequently the rule rather than the exception in the experimental or trial setting. The difference between the clinical trial setting (efficacy) and actual practice (effectiveness) should be borne in mind before the recommendation of any new therapy as the standard of care. With this in mind, we examined the effectiveness and safety of dual therapy on a cohort of adults with proteinuric IgA nephropathy in a usual clinical setting. The primary end point was reduction in proteinuria, which has been shown to be a significant risk factor for end-stage renal disease. [Hong Kong J Nephrol 2007;9(2):89–93]