Among kidney transplant patients with proteinuria, the angiotensin-converting enzyme (ACE) inhibitor ramipril failed to reduce the risk of end-stage renal disease and death compared with placebo (Knoll GA et al. Lancet Diabetes Endocrinol. doi:10.1016/S2213-8587(15)00368-X [published online October 22, 2015]). The unexpected trial findings stand in contrast to the benefits of ramipril for nontransplant patients with proteinuria. An accompanying editorial calls for a change in the international guidelines currently recommending ACE inhibitors as first-line treatment for transplant patients with proteinuria (Webster AC and Cross NB. Lancet Diabetes Endocrinol. doi:10.1016/S2213-8587(15)00415-5 [published October 22, 2015]).
Slomski A. ACE Inhibitors of Little Benefit to Kidney Transplant Patients . JAMA. 2015;314(24):2608. doi:10.1001/jama.2015.17189