Combination therapy an ACE inhibitor and an angiotensin receptor blocker for IgA nephropathy: a meta-analysis.
Int J Clin Pract, 2012/10;66(10):917-23.
Cheng J[1], Zhang X, Tian J, Li Q, Chen J
Affiliations
PMID: 22994326DOI: 10.1111/j.1742-1241.2012.02970.x
Impact factor: 3.149
Abstract
objective: The pathogenesis of IgA nephropathy (IgAN) is still unknown. Combination therapy with angiotensin-converting enzyme inhibitors (ACEIs) plus angiotensin receptor blockers (ARBs) might provide more benefits to IgAN patients. We conducted a systematic review to assess the efficacy of combination therapy for IgAN.
methods: The MEDLINE, EMBASE, the Cochrane Library and article reference lists were searched for randomised clinical trials (RCTs) which involved combination therapy ACEI plus ARB in only one arm. A meta-analysis was performed on the outcomes of proteinuria and renal function in IgAN patients.
results: Six RCTs involving 109 patients were included in the review. Combined treatment with ACEI plus ARB was more effective than with ACEI/ARB alone for reducing daily proteinuria. This did not translate into an improvement in GFR. Patients receiving ACEI plus ARB therapy did not have an increased risk of hyperkalemia.
conclusions: The current cumulative evidence suggests that combination therapy ACEI plus ARB may provide more benefits to IgAN patients for reducing daily proteinuria. Long-term effects of these agents on renal outcomes, and safety need to be established.
MeSH terms
Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Arterial Pressure; Drug Therapy, Combination; Glomerular Filtration Rate; Glomerulonephritis, IGA; Humans; Kidney Diseases; Proteinuria; Randomized Controlled Trials as Topic
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