Renal injury from angiotensin I converting enzyme inhibitors

Over the last decade, the treatment of hypertension has changed dramatically from the concept of stepped care, advocated in the 1970’s, to the more individualized care preferred nowadays. This phenomenon was largely due to the recent development of new classes of antihypertensives, which made it possible to adequately lower blood pressure in most patients with only one or two antihypertensive drugs, thus avoiding the need for a combination of multiple drugs. Onc of these new drug classes, the angiotensin I converting enzyme inhibitors, drew a lot of attention since these were aimed at inhibiting the formation of angiotensin II, a hormone thought to be involved in the origin of systemic hypertension.