ACE and chronic kidney disease: Nevertheless, the effects of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers on clinically meaningful outcomes, including slowing the progressive loss of kidney function and decreasing the incidence of ESKD, are more modest.4, 5, 6, 7, 8, 9 To attenuate, arrest, or reverse CKD progression, nephrologists will need to target pathogenetic mechanisms other than altered glomerular hemodynamics.10