New therapeutic strategies with combined renin-angiotensin system inhibitors for pediatric nephropathy.

Renin-angiotensin system (RAS) inhibitors may delay progression of several chronic kidney diseases in adults. Two classes of RAS inhibitors--angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)--have been shown to have renoprotective abilities. Despite their different mechanisms of action, these two drug classes appear to have comparable antiproteinuric and renoprotective properties. Preliminary investigations suggest that combination therapy with an ACE inhibitor and ARB offers additional benefit. Only a few studies with these drugs for treatment of pediatric nephrology have been conducted; however, their results are encouraging. Additional clinical trials are needed to confirm these results.