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The Role of Angiotensin-Converting Enzyme (ACE) Inhibitors in Kidney Disease – Renal Disorders
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id="primary"> <main class="site-main" id="main"> <article id="post-72" class="post-72 post type-post status-publish format-standard has-post-thumbnail hentry category-kidney-disease tag-ace-inhibitors tag-angiotensin-converting-enzyme tag-benazepril tag-chronic-kidney-disease tag-diabetic-nephropathy tag-end-stage-renal-disease tag-glomerular-filtration tag-hypertensive-nephropathy tag-proteinuria tag-renal-protection" itemtype="https://schema.org/CreativeWork" itemscope> <div class="inside-article"> <div class="featured-image page-header-image-single "> <img width="1200" height="628" src="https://renaldisorders.com/archive/wp-content/uploads/2024/10/renal-min-scaled-e1727784310675.jpg" class="attachment-full size-full" alt="" itemprop="image" decoding="async" fetchpriority="high" /> </div> <header class="entry-header"> <h1 class="entry-title" itemprop="headline">The Role of Angiotensin-Converting Enzyme (ACE) Inhibitors in Kidney Disease</h1> <div class="entry-meta"> <span class="posted-on"><time class="entry-date published" datetime="2024-10-01T17:35:58+05:30" itemprop="datePublished">October 1, 2024</time></span> <span class="byline">by <span class="author vcard" itemprop="author" itemtype="https://schema.org/Person" itemscope><a class="url fn n" href="https://renaldisorders.com/archive/author/renaldisorders/" title="View all posts by renaldisorders" rel="author" itemprop="url"><span class="author-name" itemprop="name">renaldisorders</span></a></span></span> </div> </header> <div class="entry-content" itemprop="text"> <p><span style="font-weight: 400;">Kidney disease is a global health burden in millions, especially with chronic kidney disease (CKD). CKD often progresses to end-stage renal disease (ESRD), necessitating dialysis or transplantation. A crucial therapeutic strategy in the management of CKD, thus, includes the use of angiotensin-converting enzyme (ACE) inhibitors. These drugs have gained popularity not only because they control blood pressure but also for their capacity to delay the progression of kidney diseases. The rationale behind this action mechanism is that the ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor that increases blood pressure and gradually damages the kidneys. This paper unravels the use of ACE inhibitors in renal disease management, clarifying mechanisms of action and their potential clinical benefits and their general contribution to renal protection.</span></p> <h3><b>Mechanisms of ACE Inhibitors in Kidney Disease</b></h3> <p><span style="font-weight: 400;">ACE inhibitors exert their renal protective actions through various pathways, mainly through the inhibition of RAAS activity. Angiotensin II leads to vasoconstriction, which increases pressure within the renal glomeruli. High pressure can result in damage to the glomeruli and permit proteins to leak into the urine of the proteinuria, an early indicator of progressive kidney disease. Through the inhibition of angiotensin II formation, ACE inhibitors lower the pressure within the glomeruli and, accordingly, proteinuria, thus offering significant renal protection.</span></p> <p><span style="font-weight: 400;">Antihypertensive effects apart, ACE inhibitors have an organ-specific protective action on the kidney. ACE inhibitors cause vasodilation, enhance blood supply, and decrease glomerular hyperfiltration. The mechanisms are better known to reduce the comorbidity associated with CKD by protecting the intricately beautiful structure of the kidneys and slowing its progression. In addition, ACE inhibitors have been demonstrated to diminish inflammatory and fibrotic changes in the kidneys, critical for the pathogenesis of ESRD. Because it is possible to treat all the pathways at once, ACE inhibitors are the cornerstone of CKD treatment, especially in those who have comorbid conditions such as hypertension and diabetes.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Yearwise Publication Trend on <b>“<a href="https://renaldisorders.com/publication-trends/index/kidney disease" target="_blank" title="kidney disease - yearwise publication trends">kidney disease</a>”</b></h2> </div> </div><div class="results-container"><div class="chart-block" style="padding:15px;"> <div class="left"> <div id="results" class="results"></div> </div> <div class="right"> <div class="chart-container"><canvas id="publicationChart"></canvas></div> </div> <div class="keywordsdiv"> <div style="text-align:center;"><b>Find publication trends on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-stats"></span> </div> </div></div></div><div class="inside-article"><style> table { margin: 0 0 1.5em; 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if (!statistics || Object.keys(statistics).length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var tableHTML = `<div class='pub-scroll'> <table class='tablediv' border='1' cellspacing='0' cellpadding='0'> <tr> <th>Year</th> <th>Publication Count</th> </tr>`; Object.entries(statistics).sort(([yearA], [yearB]) => yearB - yearA).forEach(([year, count]) => { const displayCount = count === 0 ? 'NA' : count; tableHTML += ` <tr> <td>${year}</td> <td>${displayCount}</td> </tr> `; }); tableHTML += '</table></div>'; resultsContainer.innerHTML = tableHTML; } function displayLineChart(statistics) { var years = Object.keys(statistics); var counts = Object.values(statistics); var ctx = document.getElementById('publicationChart').getContext('2d'); // Destroy existing chart instance if it exists if (chart !== null) { chart.destroy(); } // Create a new chart instance chart = new Chart(ctx, { type: 'line', data: { labels: years, datasets: [{ label: 'Publication Counts', data: counts, fill: false, borderColor: 'rgba(75, 192, 192, 1)', tension: 0.1 }] }, options: { scales: { y: { beginAtZero: true } }, plugins: { legend: { display: true, position: 'top' } } } }); } function displayKeywordStats(keywords) { var resultsContainer = document.getElementById('keyword-stats'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach((key, index) => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://renaldisorders.com/publication-trends/index/${key_replace}" target="_blank" title="${key} - yearwise publication trends">${key}</a>`; if (index < keywords.length - 1) { keywordHTML += ', '; } }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var statistics = { "2014": 2329, "2015": 2715, "2016": 3768, "2017": 3871, "2018": 4553, "2019": 6252, "2020": 10021, "2021": 11887, "2022": 14491, "2023": 24420, "2024": 9967 }; var keywordsArray = ["ACE inhibitors","chronic kidney disease","renal protection","proteinuria","glomerular filtration","hypertensive nephropathy","diabetic nephropathy","end-stage renal disease","benazepril","angiotensin-converting enzyme"]; displayResults(statistics); displayLineChart(statistics); displayKeywordStats(keywordsArray); </script></p> <h3><b>Clinical Benefits of ACE Inhibitors on CKD</b></h3> <p><span style="font-weight: 400;">Despite several clinical trials demonstrating that ACE inhibitors actually favor improved renal outcomes for patients with CKD, the most significant benefit is the reduction in proteinuria, which is associated with a slowing of the progression of renal disease. Proteinuria reflects the degree of renal damage, so its reduction is thereby an important measure of therapeutic success. In clinical trials, ACE inhibitors have consistently provided a capacity to reduce proteinuria levels on the protective of the long-term preservation of kidney function.</span></p> <p><span style="font-weight: 400;">Its use in patients with advanced chronic renal insufficiency has been proven to provide excellent renal benefits. For instance, it was found out that this class of drugs, particularly ACE inhibitors like benazepril, has significantly reduced the risk of doubling serum creatinine levels, an indication of worsening renal function among patients with advanced kidney disease that is not diabetic in origin. Moreover, ACE inhibitors provided substantial contributions to reduced progression toward ESRD and disease onset with end-stage renal disease requiring dialysis or renal transplant. All such outcomes reveal the importance of early initiation with ACE inhibitors among patients diagnosed with advanced CKD and may delay more severe renal outcomes.</span></p> <p><span style="font-weight: 400;">As discussed, ACE inhibitors are very effective in retarding the progression of kidney disease in diabetic patients, who are known to be at a high risk of developing nephropathy. Diabetic nephropathy is one of the most common causes of ESRD, and the use of ACE inhibitors in these patients has been associated with associated favorable outcomes. In diabetic patients, the use of ACE inhibitors retards the progression of the disease by reducing glomerular hyperfiltration and proteinuria, thus delaying the onset of end-stage renal disease requiring renal replacement therapy.</span></p> <h3><b>ACE Inhibitors in Hypertensive Nephropathy</b></h3> <p><span style="font-weight: 400;">Hypertension is one of the causes and effects of CKD. Management and treatment of hypertension are thus crucial in the prevention of damage to the kidneys. ACE inhibitors especially provide useful blood pressure control with the added reduction in renal damage. Glomerulosclerosis caused by prolonged hypertension further accelerates the generally reduced renal function associated with hypertensive nephropathy. These consequences are prevented by ACE inhibitors, as they reduce both systemic blood pressure and the pressure within the glomeruli, that is, the filtering units of the kidneys.</span></p> <p><span style="font-weight: 400;">In patients with hypertensive nephropathy, ACE inhibitor therapy has been successfully used to significantly slow the rate of progression of kidney disease. The study from the patients with hypertension and advanced renal insufficiency showed that ACE inhibitors not only would lower blood pressure but also slow the decline of kidney function. This two-pronged effect is particularly useful in hypertensive patients with CKD, where both systemic and renal-specific forces push forward the progression of disease.</span></p> <h3><b>Ace Inhibitors in Nondiabetic CKD</b></h3> <p><span style="font-weight: 400;">While most attention to ACE inhibitors has been directed to their potential role in diabetic nephropathy, they also prove highly effective in nondiabetic CKD. In nondiabetic patients, ACE inhibitors have clearly been associated with slowing the progression of kidney disease through reduction of both proteinuria and glomerular hyperfiltration. Even in nondiabetic patients with advanced renal insufficiency, ACE inhibitors have been shown to reduce risk significantly for the progression to ESRD.</span></p> <p><span style="font-weight: 400;">Patients with nondiabetic CKD who were given benazepril experienced a major reduction in the doubling of serum creatinine and progression to ESRD in a highly successful trial. This strongly underscores the renal-protective effect of ACE inhibitors in patients beyond those with diabetes. The specific substrates for the injury in the kidney are also pivotal, with ACE inhibitors emerging as an important arm in the treatment of CKD across a wide group of patients.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Recent Publications on <b>“<a href="https://renaldisorders.com/recent-publications/index/kidney disease" target="_blank" rel="noopener" title="kidney disease - yearwise publication list">kidney disease</a>”</b></h2> </div> </div> <div class="pb-main"><div class="article-scroll"><div id="results_recent" class="results"></div></div><div class="keywordsdiv" style="margin: 0px 15px;margin-top:20px;"> <div style="text-align:center;"><b>Find publications on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-papers"></span> </div></div></div><div class="inside-article"> <style> .pb-main{ border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .author-main { border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .publication-block { padding: 10px; margin-bottom: 10px; background-color: #f9f9f9; text-align: left; background: #FFF; border-bottom: solid 1px #ccc; margin-left: 15px; margin-right: 15px; } .publication-block h3 { margin: 0 0 10px; color: #000!important; } .publication-block a { font-size: 16px !important; line-height: 1em; font-weight: 600; text-transform: none; color: #000; padding: 0px; } .publication-block a:hover{ color: #227cdc; text-decoration:underline; } .article-scroll { max-height: 445px; overflow-y: auto; overflow-x: hidden; } ::-webkit-scrollbar-track { -webkit-box-shadow: inset 0 0 6px rgba(0,0,0,0.3); background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar { width: 6px; background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar-thumb { background-color: #ababab; border-radius:30px; } .publication-block p { margin-bottom: .5em; font-size: 15px; color: #000; } h3 { font-size: 18px !important; margin-bottom: 20px; line-height: 1.2em; font-weight: 600; text-transform: none; } a { padding: 5px; color: #a71c49; } #keyword-papers{ margin-top: 20px; text-align: center; } </style> <script> function decodeString(str) { str = str.replace(/\\'/g, "'"); str = str.replace(/\\'/g, "'"); str = str.replace(/\\'/g, "'"); return str; } function displayResults_recent(papers) { var resultsContainer = document.getElementById('results_recent'); if (!papers || papers.length === 0) { resultsContainer.innerHTML = '<p>No recent publications found.</p>'; return; } papers.forEach(paper => { var publicationBlock = document.createElement('div'); publicationBlock.className = 'publication-block'; var title_de = decodeString(paper.title); var publicationHTML = ` <div style="margin-bottom: 10px;line-height: 24px;"><a href="${paper.url}" target="_blank" title="${title_de}">${title_de}</a></div> <p><strong>Issue Release:</strong> ${paper.publishedDate}</p> `; publicationBlock.innerHTML = publicationHTML; resultsContainer.appendChild(publicationBlock); }); } function displayKeywordPapers(keywords) { var resultsContainer = document.getElementById('keyword-papers'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach((key, index) => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://renaldisorders.com/recent-publications/index/${key_replace}" target="_blank" title="${key} - publication list">${key}</a>`; if (index < keywords.length - 1) { keywordHTML += ', '; } }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var recent_papers = [ { "title": "Cost-effectiveness of add-on empagliflozin versus standard of care in management of CKD in Malaysia, Thailand and Vietnam - findings from a modelling study assessing an EMPA-KIDNEY eligible population, using CKD progression model.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38916150", "publishedDate": "2024" }, { "title": "Tubulocystic Carcinoma of Bile Ducts: A Distinct Type of Cholangiocarcinoma Associated With Adenofibroma-type Lesions.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946053", "publishedDate": "2024" }, { "title": "Renal Complications in Portal Hypertension.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945640", "publishedDate": "2024" }, { "title": "A rare presentation of isolated candidal hepatic abscess in a maintenance hemodialysis patient.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945692", "publishedDate": "2024" }, { "title": "Association between dietary protein intake and risk of chronic kidney disease: a systematic review and meta-analysis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946781", "publishedDate": "2024" }, { "title": "Clonal hematopoiesis of indeterminate potential contributes to accelerated chronic kidney disease progression.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946975", "publishedDate": "2024" }, { "title": "Chronic Kidney Disease Study in Diabetic Patients: Insights From Primary Care Units in Northern Portugal.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947587", "publishedDate": "2024" }, { "title": "Activation of TAS2R4 signaling attenuates podocyte injury induced by high glucose.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38942091", "publishedDate": "2024" }, { "title": "Comfort Level of Patients Undergoing Hemodialysis and Associated Factors in Turkey: A Cross-Sectional Study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38943304", "publishedDate": "2024" }, { "title": "Sodium Tungstate (NaW) Decreases Inflammation and Renal Fibrosis in Diabetic Nephropathy.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38944202", "publishedDate": "2024" }, { "title": "IGF2BP3\/NCBP1 complex inhibits renal tubular senescence through regulation of CDK6 mRNA stability.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945255", "publishedDate": "2024" }, { "title": "Management of Massive Flank Hernia After Lateral Lumbar Fusion: Preoperative Botulinum Toxin Injections and Open Repair - A Case Report.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946127", "publishedDate": "2024" }, { "title": "Association between machine learning-assisted heavy metal exposures and diabetic kidney disease: a cross-sectional survey and Mendelian randomization analysis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947355", "publishedDate": "2024" }, { "title": "Relapsing nephrotic syndrome with acute renal failure following a unique episode of multiple bee stings: A case report.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947546", "publishedDate": "2024" }, { "title": "Brincidofovir inhibits polyomavirus infection .", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38953354", "publishedDate": "2024" }, { "title": "Combining telemedicine and in-person visits to deliver care to patients with severe chronic kidney disease (CKD): Lessons learned from COVID-19.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38953545", "publishedDate": "2024" }, { "title": "Recent developments in the management of resistant hypertension: focus on endothelin receptor antagonists.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38953510", "publishedDate": "2024" }, { "title": "Wearable device-measured moderate to vigorous physical activity and risk of degenerative aortic valve stenosis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38953786", "publishedDate": "2024" }, { "title": "Inflammation primes the murine kidney for recovery by activating AZIN1 adenosine-to-inosine editing.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38954486", "publishedDate": "2024" }, { "title": "Association between serum magnesium levels and cognitive function in patients undergoing hemodialysis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38954308", "publishedDate": "2024" } ]; var keywordsArray = ["ACE inhibitors","chronic kidney disease","renal protection","proteinuria","glomerular filtration","hypertensive nephropathy","diabetic nephropathy","end-stage renal disease","benazepril","angiotensin-converting enzyme"]; displayResults_recent(recent_papers); displayKeywordPapers(keywordsArray); // function stripslashes(str) { // if (typeof str === 'string') { // return str.replace(/\/g, ''); // } // } </script></p> <h3><b>Safety and Tolerability of ACE Inhibitors</b></h3> <p><span style="font-weight: 400;">Despite the highly protective effects of ACE inhibition on both the kidneys and the cardiovascular system, the side effects should not be neglected. The most frequent adverse effects include hyperkalemia, or elevated levels of potassium in the blood, which may be dangerous if untreated. Advanced CKD patients, especially, are at significant risk of developing hyperkalemia because their kidneys are less capable of excreting potassium. Therefore, it is critically important to monitor the levels of plasma potassium when ACE inhibitors are started or administered in CKD patients, especially in those with more advanced disease.</span></p> <p><span style="font-weight: 400;">Another side effect that may be induced by ACE inhibitors is a falling rate of kidney function some time after initiation of therapy. Most of the patients will have a transient decline, known as an acute kidney injury, that resolves as their blood pressure stabilizes. In some patients, however, the AKI will be severe enough to require discontinuation of the drug. The benefits in terms of prevention of progression of CKD outweigh the short-term risks in most patients.</span></p> <p><span style="font-weight: 400;">Other side effects that should also be watched out for include cough, a frequent side effect associated with the administration of ACE inhibitors, since bradykinin, a substance that ACE in normal conditions degrades, accumulates. In patients in whom ACE inhibitors cannot be tolerated on the basis of cough, alternative agents such as angiotensin II receptor blockers (ARBs) may be substituted; these agents provide similar renoprotection without the side effects of bradykinin.</span></p> <h3><b>Conclusion</b></h3> <p><span style="font-weight: 400;">ACE inhibitors have become a main role in the treatment of CKD, providing substantial renoprotection and cardiovascular benefits for a diverse population of patients. Being so in the ability to reduce proteinuria, control blood pressure, and prevent progression of kidney disease, they are becoming a modality of CKD treatment, especially in patients with comorbid conditions like hypertension and diabetes. In this regard, ACE inhibitors would address the underlying mechanisms causing the kidney damage and provide long-term protection against ESRD and subsequent dialysis or renal transplant. As the research continues to evolve, ACE inhibitors are likely to remain core therapy in the pursuit of saving millions of patients from kidney disease and improving their quality of life.</span></p> <p></p> <h3><b>References</b></h3> <ol> <li>Hou, F.F., Zhang, X., Zhang, G.H., Xie, D., Chen, P.Y., Zhang, W.R., Jiang, J.P., Liang, M., Wang, G.B., Liu, Z.R. and Geng, R.W., 2006. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa053107">Efficacy and safety of benazepril for advanced chronic renal insufficiency. </a><i>New England Journal of Medicine</i>, <i>354</i>(2), pp.131-140.</li> <li>Lewis, E.J., Hunsicker, L.G., Clarke, W.R., Berl, T., Pohl, M.A., Lewis, J.B., Ritz, E., Atkins, R.C., Rohde, R. and Raz, I., 2001. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa011303">Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes.</a> <i>New England Journal of Medicine</i>, <i>345</i>(12), pp.851-860.</li> <li>Brenner, B.M., Cooper, M.E., De Zeeuw, D., Keane, W.F., Mitch, W.E., Parving, H.H., Remuzzi, G., Snapinn, S.M., Zhang, Z. and Shahinfar, S., 2001. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa011161">Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. </a><i>New England journal of medicine</i>, <i>345</i>(12), pp.861-869.</li> <li>Perkovic, V., Jardine, M.J., Neal, B., Bompoint, S., Heerspink, H.J., Charytan, D.M., Edwards, R., Agarwal, R., Bakris, G., Bull, S. and Cannon, C.P., 2019. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1811744">Canagliflozin and renal outcomes in type 2 diabetes and nephropathy.</a> <i>New England journal of medicine</i>, <i>380</i>(24), pp.2295-2306.</li> <li>Wanner, C., Inzucchi, S.E., Lachin, J.M., Fitchett, D., von Eynatten, M., Mattheus, M., Johansen, O.E., Woerle, H.J., Broedl, U.C. and Zinman, B., 2016. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1515920">Empagliflozin and progression of kidney disease in type 2 diabetes.</a> <i>New England Journal of Medicine</i>, <i>375</i>(4), pp.323-334.</li> </ol> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Top Experts on “<b style="color:#000;font-size:22px;">kidney disease</b>“</h2> </div> </div><div class="author-main"><div id="results_author"></div><div style="text-align: center;"><a class="register-button" href="https://renaldisorders.com/expert-search" target="_blank" rel="noopener">Find experts on any field</a></div></div><div class="inside-article" style="background: none;border: none;box-shadow: none;margin-top: -70px;"> <style> .author-block { padding: 15px; 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", "email": "jonathan.craig@flinders.edu.au", "slug_tail": "j-craig" } }; //console.log(authors_data); displayResults_author(authors_data); var keywordsArray = ["ACE inhibitors","chronic kidney disease","renal protection","proteinuria","glomerular filtration","hypertensive nephropathy","diabetic nephropathy","end-stage renal disease","benazepril","angiotensin-converting enzyme"]; displayKeywordAuthors(keywordsArray); </script></p> </div> <footer class="entry-meta" aria-label="Entry meta"> <span class="cat-links"><span class="gp-icon icon-categories"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M0 112c0-26.51 21.49-48 48-48h110.014a48 48 0 0143.592 27.907l12.349 26.791A16 16 0 00228.486 128H464c26.51 0 48 21.49 48 48v224c0 26.51-21.49 48-48 48H48c-26.51 0-48-21.49-48-48V112z" /></svg></span><span class="screen-reader-text">Categories </span><a href="https://renaldisorders.com/archive/category/kidney-disease/" 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