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AIPRI
ACE Inhibition in Progressive Renal Insufficiency
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Author(s) |
Maschio G, Alberti D, Locatelli F, Mann JFE, Motolese M, Ponticelli C, Ritz E, Janin G, Zucchelli P, and the ACE Inhibition in Progressive Renal Insufficiency (AIPRI) Study Group
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Title(s) |
Angiotensin-converting enzyme inhibitors and kidney protection: the AIPRI trial
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Reference(s) |
J Cardiovasc Pharmacol 1999;33 Suppl 1:S16-20
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Disease |
Mild to moderate renal failure
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Purpose |
To determine whether benazepril is safe and effective in protecting residual renal function in patients with mild to moderate renal failure of various origins
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Study design |
Randomised, double-blind, placebo-controlled
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Follow-up |
36 months
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Patients |
583 patients with chronic renal failure stratified according to creatinine clearance as mild (46-60 ml/min, 227 patients) or moderate (30-45 ml/min, 356 patients)
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Treatment regimen |
Benazepril, 10 mg once daily, or placebo
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Concomitant therapy |
Antihypertensives as needed, adjusted to maintain DBP < 90 mm Hg
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Results |
31 patients receiving benazepril and 57 patients receiving placebo reached the endpoint (a doubling of serum creatinine level and start of renal replacement therapy) (p < 0.001 at 3 years), representing an overall 53% reduction in the relative risk of reaching the endpoint in benazepril-treated patients. After adjustment for DBP, the overall risk reduction was 38%, with a greater reduction in patients with mild renal failure, DBP < 90 mm Hg or proteinuria > 1.0 g/24 h at baseline. Actuarial renal survival probability was significantly better at 3 years in the benazepril group (p < 0.01). Best survival of renal function was observed in patients with glomerular diseases, renal failure of unknown origin, and diabetic nephropathy
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