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Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial

Ruggenenti, Piero, Perna, Annalisa, Loriga, Giacomina, Ganeva, Maria, Ene-Iordache, Bogdan, Turturro, Marta, Lesti, Maria, Perticucci, Elena, Chakarski, Ivan Nediyalkov, Leonardis, Daniela, Garini, Giovanni, Sessa, Adalberto, Basile, Carlo, Alpa, Mirella, Scanziani, Renzo, Sorba, Gianbattista, Zoccali, Carmine, Remuzzi, Giuseppe·2005·The Lancet

Abstract

BACKGROUND In chronic nephropathies, inhibition of angiotensin-converting enzyme (ACE) is renoprotective, but can further renoprotection be achieved by reduction of blood pressure to lower than usual targets? We aimed to assess the effect of intensified versus conventional blood-pressure control on progression to end-stage renal disease. METHODS We undertook a multicentre, randomised controlled trial of patients with non-diabetic proteinuric nephropathies receiving background treatment with the ACE inhibitor ramipril (2.5-5 mg/day). We randomly assigned participants either conventional (diastolic <90 mm Hg; n=169) or intensified (systolic/diastolic <130/80 mm Hg; n=169) blood-pressure control. To achieve the intensified blood-pressure level, patients received add-on therapy with the dihydropyridine calcium-channel blocker felodipine (5-10 mg/day). The primary outcome measure was time to end-stage renal disease over 36 months' follow-up, and analysis was by intention to treat. FINDINGS Of 338 patients who were randomised, three (two assigned intensified and one allocated conventional blood-pressure control) never took study drugs and they were excluded. Over a median follow-up of 19 months (IQR 12-35), 38/167 (23%) patients assigned to intensified blood-pressure control and 34/168 (20%) allocated conventional control progressed to end-stage renal disease (hazard ratio 1.00 [95% CI 0.61-1.64]; p=0.99). INTERPRETATION In patients with non-diabetic proteinuric nephropathies receiving background ACE-inhibitor therapy, no additional benefit from further blood-pressure reduction by felodipine could be shown.

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Metadata

Authors
Ruggenenti, P., Perna, A., Loriga, G., Ganeva, M., Ene-Iordache, B., Turturro, M., Lesti, M., Perticucci, E., Chakarski, I. N., Leonardis, D., Garini, G., Sessa, A., Basile, C., Alpa, M., Scanziani, R., Sorba, G., Zoccali, C., & Remuzzi, G.
Venue
The Lancet
Publisher
Elsevier BV
Published
2005-03
Volume
365
Issue
9463
Pages
939-946
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2059647022
Cited by
644
References
5
FWCI
21.47
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial. https://app.cochat.ai/papers/10.1016/s0140-6736(05)71082-5
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Ruggenenti, P., Perna, A., Loriga, G., Ganeva, M., Ene-Iordache, B., Turturro, M., Lesti, M., Perticucci, E., Chakarski, I. N., Leonardis, D., Garini, G., Sessa, A., Basile, C., Alpa, M., Scanziani, R., Sorba, G., Zoccali, C., & Remuzzi, G. (2005). Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial. The Lancet. https://doi.org/10.1016/s0140-6736(05)71082-5

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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