Ramipril no benefit after renal transplant, more studies needed

kidneytransplant2

Greg A Knoll, MD et al. Ramipril versus placebo in kidney transplant patients with proteinuria: a multicentre, double-blind, randomised controlled trial. The Lancet Diabetes & Endocrinology, October 2015 DOI: 10.1016/S2213-8587(15)00368-X

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Ramipril, an angiotensin converting enzyme (ACE) inhibitor, has long been used to reduce proteinuria in kidney diseases. Increasing or persistent proteinuria is often a poor prognostic indicator. Post renal transplant, ramipril has been used to reduce proteinuria, which is a loss of protein in the urine.

This article by Dr Knoll et al does put a damper on the benefits of actually prescribing Ramipril solely to reduce proteinuria. Efficacy and safety of ramipril in hypertensive post renal transplant patients has been shown previously here.

What is needed now is reproducibility and perhaps in a multi centered setting, before a change in treatment protocols.