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Previous Volume 354:131-140 January 12, 2006 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Hebert, L. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Angiotensin-converting–enzyme inhibitors provide renal protection in patients with mild-to-moderate renal insufficiency (serum creatinine level, 3.0 mg per deciliter or less). We assessed the efficacy and safety of benazepril in patients without diabetes who had advanced renal insufficiency.

Methods We enrolled 422 patients in a randomized, double-blind study. After an eight-week run-in period, 104 patients with serum creatinine levels of 1.5 to 3.0 mg per deciliter (group 1) received 20 mg of benazepril per day, whereas 224 patients with serum creatinine levels of 3.1 to 5.0 mg per deciliter (group 2) were randomly assigned to receive 20 mg of benazepril per day (112 patients) or placebo (112 patients) and then followed for a mean of 3.4 years. All patients received conventional antihypertensive therapy. The primary outcome was the composite of a doubling of the serum creatinine level, end-stage renal disease, or death. Secondary end points included changes in the level of proteinuria and the rate of progression of renal disease.

Results Of 102 patients in group 1, 22 (22 percent) reached the primary end point, as compared with 44 of 108 patients given benazepril in group 2 (41 percent) and 65 of 107 patients given placebo in group 2 (60 percent). As compared with placebo, benazepril was associated with a 43 percent reduction in the risk of the primary end point in group 2 (P=0.005). This benefit did not appear to be attributable to blood-pressure control. Benazepril therapy was associated with a 52 percent reduction in the level of proteinuria and a reduction of 23 percent in the rate of decline in renal function. The overall incidence of major adverse events in the benazepril and placebo subgroups of group 2 was similar.

Conclusions Benazepril conferred substantial renal benefits in patients without diabetes who had advanced renal insufficiency. (ClinicalTrials.gov number, NCT00270426 [ClinicalTrials.gov] .)

Source Information

From the Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Address reprint requests to Dr. Hou at the Renal Division, Nanfang Hospital, 1838 N. Guangzhou Ave., Guangzhou 510515, China, or at ffhou{at}public.guangzhou.gd.cn.

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Benazepril for Advanced Chronic Renal Insufficiency
Bloom J. M., Jaber B. L., Madias N. E., Hou F. F., Zhang X.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:1530-1531, Apr 6, 2006. Correspondence

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