ACE inhibitors in non-diabetic renal disease

In non-diabetic renal disease ACE inhibitors have brought both benefit and problems. On the one hand, they are undoubtedly effective antihypertensive agents and data suggest that they may have a beneficial role in the prevention of progression of renal disease, although further placebo controlled double blind trials of adequate duration are required. On the other hand, their widespread use in elderly patients and those with generalised atherosclerosis has increased the risk of acute renal failure when occult renovascular disease is present. Awareness among physicians of the high rate of renovascular disease in populations at risk is to be encouraged.