Renal failure, chronic, in non-diabetic and non-nephrotic patients: angiotensin blockage with ACEI or ARB for reducing progression of renal failure
DISEASE INTERVENTION COMPARISON RESULTS
Ann Intern Med. 2001 Jul 17;135(2):73-87 Meta-Analysis
IN kidney disease, chronic, non diabetic The Use of
angiotensin converting enzyme inhibitors (ACEI)
As Treatment, Chronic
Is better Than
antihypertensive regimens not including ACEI
To reduce progression to end-stage renal failure (RR 0.7). The higher the uninary protein excrection, the higher the benefit.
Lancet. 1999 Jul 31;354(9176):359-64 Randomized Controlled Trial
IN kidney disease, chronic, non diabetic The Use of
angiotensin converting enzyme inhibitors (ACEI), ramipril
As Treatment, Chronic
Is better Than
placebo plus conventional antihypertensive therapy
To reduce progression to end-stage renal failure: 9% ACEI VS 20% controls
Lancet. 2003 Jan 11;361(9352):117-24 Randomized Controlled Trial
IN kidney disease, chronic, non diabetic The Use of
combination of angiotensin converting enzyme inhibitor (trandolapril) plus angiotensin II receptor blockers (losartan)
As Treatment, Chronic
Is better Than
monotherapy with either of both drugs. No comparison with placebo, however.
To reducing combined endpoint of doubling of serum creatinine concentration or end-stage renal disease (11% combined Tt / 23% both monotherapies)
N Engl J Med. 2006 Jan 12;354(2):131-40 Randomized Controlled Trial
IN kidney disease, chronic, non diabetic, severe The Use of
angiotensin converting enzyme inhibitor, benazepril (20 mg/d)
As Treatment, Chronic
Is better Than
placebo
To reduce progession (doubling initial creatinine or end-stage renal failure) at 3.4 years: 60% with placebo VS 41% using benazepril. Hypertension control was similar, proteinuria was reduced