What are the benefits of using ACE-Is or ARBs in patients with CKD and urine albumin excretion 4300 mg per 24 hours?
In RCTs involving patients with CKD and urine albumin excretion 4300 mg per 24 hours, ARBs or ACE-Is reduce the risks of hard outcomes such as the doubling of SCr level, kidney failure, or death. A meta-analysis of individual patient data from 11 RCTs compared antihypertensive regimens including ACE-Is to regimens without ACE-Is in 1860 patients with predominantly non-diabetic CKD. In adjusted analyses, ACE-Is were associated with a HR of 0.69 for kidney failure (95% CI 0.51 0.94) and 0.70 for the combined outcome of doubling of the baseline SCr concentration or kidney failure (95% CI 0.55 0.88).