In patients with CKD, does dual-RAS inhibition compared to mono-RAS inhibition improve clinical efficacy outcomes and reduce adverse effects?
A Cochrane review by Strippoli GFM, et al. found that dual-RAS inhibition compared to mono-RAS inhibition can reduce the progression of diabetic kidney disease in adults with CKD (CKD G1 G5 without kidney transplant) and with and without diabetes (T1D and T2D). The review also found that dual-RAS inhibition can improve clinical efficacy outcomes and reduce adverse effects, as compared to mono-RAS inhibition. Critical and important harms were listed in Table 1 of the review. The evidence was based on randomized controlled trials (RCTs).  