Studies in nondiabetic CKD also support the use of ACEIs.In
the
REIN-2
(Ramipril
Efficacy
In
Nephropathy-2)study, patients with mean SCr of 2.4 mg/dl and proteinuria43 g/day
of
were
randomized
to
ramipril
or
placebo;ramipril showed significant reductions in proteinuria, GFRdecline, and the risk of SCr doubling or ESRDcompared withplacebo, even after adjustment for changes in BP.48 In theAASK
trial,
ramipril
showed
a
of
36%
GFR,
reduction
in
thecomposite
of
50%
reduction
ESRD,
or
death