Dr KK Answers: Can ACE inhibitor be combined with ARB in CKD

In a post-hoc analysis of patients with reduced renal function and/or proteinuria from the ONTARGET and TRANSCEND trials combination therapy was associated with a small but significantly increased incidence of end stage renal disease or doubling of the serum Creatinine.

 In patients who had both reduced renal function and proteinuria, combination therapy was associated with a significantly increased risk of ESRD or doubling of the serum Creatinine. Circulation 2011; 123:1098