I have CDK and was on Ramipril and Irbesartan for many years. In July, my creatinine level was 3.0 mg/dl, and 24 hour protein 620mg. My nephrologist suspended the ACE-inhibitors therapy because my blood pressure was really low (90-60). After 2 months, creatinine levels had increased to 3.6 and protein to more than 3g. Could this be a consequence of suspending ACE therapy? I’ve been given cortisone for the proteinuria, to no effect, and beta-blockers for blood pressure rather than ACE inhibitors. Creatinine is at 5 now, and proteinuria is still high.

ACE-inhibitors or ARB agents can be used to treat chronic kidney disease (CKD).  The Ramipril you mentioned is an ACE-inhibitor.  The Irbesartan that you mention is an ARB agent.  Either one but not both should be used to treat your CKD.  The excess protein in your urine (proteinuria) is a specific indication for use of either the ACE-inhibitor or the ARB agent.  I suggest that you discuss this with your nephrologist.

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