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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Renin+Angiotensin+Aldosterone+Syst
2016 ; 17
(3
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Protection against death and renal failure by renin-angiotensin system blockers
in patients with diabetes and kidney disease
#MMPMID27377659
Shen J
; Huang YM
; Song XN
; Hong XZ
; Wang M
; Ling W
; Zhang XX
; Zhao HL
J Renin Angiotensin Aldosterone Syst
2016[Jul]; 17
(3
): ä PMID27377659
show ga
INTRODUCTION: Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin
receptor blockers (ARBs) are widely used to block the renin-angiotensin system
(RAS). Yet it remains uncertain whether these drugs are equally effective and
safe. METHODS: Systematic reviews and meta-analyses of ACEis/ARBs in diabetes and
kidney disease published in PubMed, Chinese National Knowledge Infrastructure
(CNKI) and Wanfang databases were searched for clinical outcomes including
all-cause mortality, end-stage renal disease (ESRD), hyperkalemia and cough.
RESULTS: Eight meta-analyses included 2177-61,264 patients with follow-up of
6-108 months. RAS blockers reduced mortality (relative risk ratio (RR), 0.90, 95%
confidence interval (CI), 0.86-0.95) without heterogeneity. The death protection
was significant specifically with ACEis (RR, 0.85, 95% CI, 0.79-0.91), but not
with ARBs. Protection against ESRD was homogenously evident by ARBs (RR, 0.79,
95% CI, 0.73-0.87), ACEis (RR, 0.79, 95% , 0.64-0.94), and both (RR, 0.79, 95%
CI, 0.73-0.87). Significant side effects were hyperkalemia by ARBs (RR, 2.44, 95%
CI, 1.13-5.26), and cough by ACEis (RR, 2.38, 95% CI, 1.75-3.22) CONCLUSIONS: In
patients with diabetes and kidney disease, ACEis and ARBs are consistently
protective for the development of ESRD. Use of ACEis alone additionally reduces
deaths and increases the risk for cough. Use of ARBs alone increases the risk for
hyperkalemia without additional benefit of death protection.
|*Renin-Angiotensin System/drug effects
[MESH]
|Angiotensin II Type 1 Receptor Blockers/pharmacology/therapeutic use
[MESH]
|Angiotensin-Converting Enzyme Inhibitors/pharmacology/therapeutic use
[MESH]