Some antihypertensive drugs may have a renoprotective effect, that is parti
ally independent of their ability to reduce blood pressure. ACE-inhibitors
are safe and effective agents that are capable of reducing proteinuria and
preventing CRF progression The results of the AIPRI extension study suggest
that they may also have a long-term renoprotective effect. ACE gene polymo
rphism may partially influence the response to these agents. Angiotensin II
receptor 1 antagonists (AT1RA) are effective in reducing proteinuria, but
their clinical impact is still a matter of study. It has been shown that no
n dihydropyridine and some dihydropyridine calcium channel blockers (CCBs)
reduce proteinuria and are also renoprotective, but there is a lack of larg
e-scale prospective randomised trials. Given that the use of various drugs
is usually needed to achieve good blood pressure control in patients with C
RF, the possibility that a combination of ACE-inhibitors with CCBs or AT1RA
s may have an additive renoprotective effect is intriguing.