Effects of ACE Inhibitors and Angiotensin Receptor Blockers in Normotensive Patients with Diabetic Kidney Disease

Horm Metab Res DOI: 10.1055/a-1138-0959The role of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin
receptor blockers (ARBs) in reducing the progression of albuminuria and risk of
cardiovascular events in hypertensive patients with diabetic kidney disease
(DKD) is well-documented. However, the efficacy and safety of these agents in
normotensive patients with DKD are still controversial. MEDLINE, Embase, and
Cochrane Library were searched for relevant random controlled trials. The odd
risk (OR) reductions were calculated with a random-effects model. Decrease in
albuminuria, changes in eGFR, major cardiovascular events, and drug-related
adverse events were analyzed. Thirteen RCTs including 1282 patients were
retrieved. Compared with placebo or other active agent groups, ACEIs or ARBs
significantly decreased albuminuria (MD –80.28 mg/d,
95% CI –104.79 mg/d to
–55.77 mg/d), and the efficacy is independent of changes
in blood pressure and systolic blood pressure at baseline. The result of
subanalysis showed the declining of albuminuria was more significantly in
normotensive DKD patients with 2DM (p=0.005). No significant differences
were found with regard to the declining of evaluated glomerular filtration rate
(eGFR) (MD
–0.29 ml/min/1.73 m2,
95% CI –2.99 ...

Source: Hormone and Metabolic Research - March 26, 2020 Category: Endocrinology Authors: He, Dandan Zhang, Yaru Zhang, Wei Xing, Yue Guo, Yipeng Wang, Fuzhen Jia, Junya Yan, Tiekun Liu, Youxia Lin, Shan Tags: Endocrine Care Source Type: research