Ramipril is an angiotensin converting enzyme inhibitor (ACE-inhibitor) used to control blood pressure. It also has a beneficial long term effect on kidney function.
When the drug is first started, the estimated glomerular filtration rate (eGFR) may decline slightly but the goal is long term control of the blood pressure with preservation of kidney function. Ramipril and other ACE-inhibitors are known to be beneficial in diabetes kidney disease and kidney disease with protein in the urine. Hence, I am a strong advocate for ACE-inhibitors in treatment of chronic kidney disease CKD.