ACE-inhibitors in Extracapillary Glomerulonephritis

Inclusion Criteria: * Rapidly progressive renal failure associated with acute nephritic syndrome and/or nephrotic syndrome; * Histology evidence of extracapillary proliferation with less than 50% of sclerotic glomeruli and associated with: 1. Type I: Anti-Glomerular Basement Membrane (GBM) antibody glomerulonephritis, 2. Type II: Pauci-immune vasculitis or Anti Neutrophil Cytoplasmic Antibody (ANCA) associated vasculitis; 3. Type III: Immune-complex mediated glomerular diseases: Proliferative lupus nephritis (LN), IgA nephropathy (IgAN)/ Schönlein-Henoch purpura, Type I membranoproliferative glomerulonephropathy (MPGN), Primary or secondary membranous nephropathy (MN), Primary or idiopathic immune complex glomerulonephritis. * Clinical indication to immunosuppressive therapy; * No specific indication to treatment with Renin Angiotensin System (RAS) inhibitors such as heart failure or coronary ischemic disease; * Written informed consent. Exclusion Criteria: * Pre-existing advanced chronic renal failure (creatinine clearance less than 20 ml/min/1.73m2); * Evidence of B or C virus active infection; * HIV infection; * Recent diagnosis of malignancy; * Prolonged bleeding time and any other contraindication to kidney biopsy evaluation; * Any specific contraindication to ACE inhibitor therapy (that is: history of angioedema or other treatment-related serious adverse events); * Pregnancy or lactating; * Women of childbearing potential without following a scientifically accepted form of contraception; * Inability to understand the risks and benefit of the study or evidence of an uncooperative attitude; * Legal incapacity.