What benefits have been observed for ACEi and ARB in patients with diabetes and CKD?
When compared to placebo or standard of care, ACEi improves CV outcomes, but for ARB, there is no improvement. ACEi reduced doubling of serum creatinine by 42% (RR: 0.58; 95% CI: 0.37) and the risk of progression from moderately increased albuminuria to severely increased albuminuria decreased by 123 fewer events per 1000 patients (95%). However, there were no differences between ACEi and ARB for the discrete outcomes of all-cause mortality, CV mortality, MI, stroke, HF, and kidney function in people with diabetes and albuminuric or non-albuminuric CKD subpopulations.