Summary
Perindopril has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Chronic Kidney Disease would be drug repurposing rather than first-in-human development. This does not mean it is approved for Chronic Kidney Disease. ClinicalTrials.gov lists 5 registered trials linking Perindopril to Chronic Kidney Disease: 1 is active or not yet recruiting; 2 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT03502031). The largest enrolment is 474 participants (NCT00231803). Registration activity spans 2005 to 2026. The literature layer holds 7 publications for this pair: 1 Cochrane review, 1 randomised controlled trial publication and 5 clinical trial publications. Publication years run from 2008 to 2023. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Chronic Kidney Disease ranks 534 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: GFR decline averages 2-5 mL/min/year on standard care (ACE/ARB + blood pressure control); progression to end-stage renal disease (ESRD) in ~20-30% at 10 years for moderate CKD; reversal essentially impossible once structural fibrosis established.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 55.0 (trials 17.0, literature 18.0, tier 15, approved bonus 5.0) |
| Registered trials | 5 total: 0 recruiting, 1 active / not yet recruiting, 2 completed, 2 other |
| Linked publications | 7 (5 clinical trial publications, 1 Cochrane review, 1 randomised controlled trial publication) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | inhibitor |
| Data sources | DGIdb |
| Linked via biomarker / target | AGTR1 |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT01219413 | Influence of Aliskiren on Proteinuria 2009 | completed | Phase 4 | 16 |
| NCT07547878 | Rapid and Simultaneous Initiation of Four Guideline-Directed CKD Therapies (RAPID-CKD) 2026 | not yet recruiting | Phase 4 | 64 |
| NCT02299310 | Effect of Valsartan vs Perindopril on HOMA-IR Index in Patients With Chronic Kidney Disease 2014 | status unknown | Phase 4 | 60 |
| NCT03502031 | Safety and Efficacy of Two Year of RAAS Alone or in Combination With Spironolactone Therapy 2018 | status unknown | Phase 4 | 72 |
| NCT00231803 | The Canadian Prevention of Renal and Cardiovascular Endpoints Trial 2005 | completed | Not applicable | 474 |
Published literature
- Cochrane review Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney diseaseCooper TE, Teng C, Tunnicliffe DJ et al. · The Cochrane database of systematic reviews · 2023 · PMID 37466151
- Clinical trial publication Aliskiren attenuates oxidative stress and improves tubular status in non-diabetic patients with chronic kidney disease-Placebo controlled, randomized, cross-over studyRenke M, Lizakowski S, Tylicki L et al. · Advances in medical sciences · 2014 · PMID 25105662
- Clinical trial publication [Isoprostanes - important marker of the oxidative stress estimation in patients with chronic kidney disease]Renke M, Knap N, Tylicki L et al. · Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego · 2013 · PMID 23488278
- Clinical trial publication Effect of aliskiren on proteinuria in non-diabetic chronic kidney disease: a double-blind, crossover, randomised, controlled trialLizakowski S, Tylicki L, Renke M et al. · International urology and nephrology · 2012 · PMID 23326865
- Clinical trial publication Effects of a fixed combination of perindopril and indapamide in patients with type 2 diabetes and chronic kidney diseaseHeerspink HJ, Ninomiya T, Perkovic V et al. · European heart journal · 2010 · PMID 20501479
- Clinical trial publication Clinical study of Trilogy Detoxicating Therapy combined with routine Western medicine on patients with chronic renal failureWu XL, Sun WS, Zhang WG et al. · Chinese journal of integrative medicine · 2008 · PMID 18679599
- Randomized controlled trial Lower blood pressure and risk of recurrent stroke in patients with chronic kidney disease: PROGRESS trialNinomiya T, Perkovic V, Gallagher M et al. · Kidney international · 2008 · PMID 18272959
Mechanism and notes
Recorded mechanism or class: inhibitor.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in DGIdb, in this case via the biomarker or target AGTR1. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Perindopril approved for Chronic Kidney Disease?
Perindopril has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Chronic Kidney Disease would be drug repurposing rather than first-in-human development. This does not mean it is approved for Chronic Kidney Disease. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Perindopril in clinical trials for Chronic Kidney Disease?
ClinicalTrials.gov lists 5 registered trials linking Perindopril to Chronic Kidney Disease: 1 is active or not yet recruiting; 2 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT03502031). The largest enrolment is 474 participants (NCT00231803). Registration activity spans 2005 to 2026.
What does the evidence show for Perindopril in Chronic Kidney Disease?
Perindopril has both completed registered trials and synthesis-level publications linked to Chronic Kidney Disease. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in DGIdb, in this case via the biomarker or target AGTR1. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.