Aliskiren is the only available orally active renin inhibitor blocking its catalytic activity. Based on prematurely terminated ALTITUDE study in high-risk patients with 2 diabetes type, who were treated with ACE inhibitors or AT1-blockers, The European Medicines Agency recommends not to use aliskiren in patients with diabetes or patients with moderate to severe renal impairment who are currently treated with ACE inhibitors or AT1-blockers.