What are the benefits of treating CKD patients with RASi compared to placebo or active therapy?
A network meta-analysis by Xie et al., including 119 RCTs (n 64,768), examined the benefits of treating with RASi compared to placebo or active therapy in patients with CKD for kidney and CVoutcomes and included studies with and without diabetes and albuminuria. The results demonstrated that both ACEi and ARBs reduced the risk of kidney failure (defined as a composite of any of the following: doubling of serum creatinine, 50% decline in GFR, or ESKD) by 39% and 30%, respectively, compared to placebo with high certainty; and 35% and 25%, respectively, against active controls with moderate certainty.