ACE and chronic kidney disease: [36] In one study, the unadjusted analysis demonstrated a lower risk of mortality with higher HgbA1C levels but the adjusted analysis demonstrated a higher risk, suggesting that HgbA1C levels may be a marker of underlying health status. [30] The two studies examining the effects of ACE-inhibitors on cardiovascular outcomes among patients with DM demonstrated either no differences according to the presence or absence of CKD [31] or greater risk reduction among patients with renal disease [32].