The aim of our study was an analysis of data obtained from a prospective long-term randomized multicentric study designed to evaluate the effect of concomitant administration of ACE inhibitors (ACEI) and angiotensin II AT1 receptor antagonist (AT1B) on proteinuria and aminoaciduria in patients in chronic renal insufficiency (CRI) on a low-protein diet (LPD) with keto amino acid (KA). The study was designed to monitor, over a 12-month period, a total of 50 patients randomized into group I (25 patients) receivingLPD (0.6 g protein/kg/day), keto acids (100 mg/kg/day), ACEI (perindopril 4 mg/d) and AT1B (candesartan 8 mg/day) and group II (25 patients) given LPD, KA and ACEI in equal doses. Examinations performed at the start and at 2-month intervals demonstrated a significant decrease in proteinuria (P < 0.01) predominantly in group I associated with improved protein metabolism parameters. At the same time, slower CRI progression was observed as assessed using inulin clearance (P < 0.01). ACEI and AT1B co-administration had a beneficial effect on the examined metabolic parameters and, via its glomerulo-tubular action, it also had an effect on the long-term progression of CRI.

        Key words: proteinuria, ACE inhibitors, AT1 receptor blockers.