Nondiabetic Kidney Disease

To the Editor: In his Clinical Practice article (Nov. 7 issue) 1 Dr. Levey states, “If an ACE [angiotensin-converting–enzyme] inhibitor is contraindicated because of cough or angioedema, then an angiotensin-receptor blocker would be a logical alternative.” Although an angiotensin-receptor blocker would be a logical and safe alternative for someone with an ACE-inhibitor–related cough, the same cannot be said about someone who has previously had angioedema due to the use of an ACE inhibitor. There have been several reports of angioedema induced by the use of an angiotensin-receptor blocker in patients who had previously had angioedema while taking an ACE inhibitor. The . . .