01191nas a2200145   4500000000100000008004100001100001700042700001600059245005200075250001500127300001200142490000800154520083700162020004600999       2010                            d1 aHeerspink H.1 ade Zeeuw D.00aDual RAS therapy not on target, but fully alive  a2010/06/03  ac137-420 v1163 a<p>
Inhibitors of the renin-angiotensin system (RAS) form a cornerstone in the treatment of kidney disease. These drugs lower blood pressure and albuminuria, and afford renal protection. Dual therapy with an angiotensin-converting enzyme inhibitor and angiotensin receptor blocker have been shown to be more effective in reducing blood pressure and albuminuria than the single use of these agents. It was therefore expected that the combination of these drugs could delay the progression of renal disease. However, the ONTARGET renal analysis suggests that the use dual-agent RAS leads to increased renal risk. This led to vivacious discussions about the benefits and risks of dual-agent RAS in patients with nephropathy. We will review the ONTARGET trial design and interpretation, and offer implications for novel trials.
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  a1660-2110 (Electronic)1660-2110 (Linking)