Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers for renal outcomes and mortality in diabetic kidney disease

Published:November 26, 2020DOI:


      • A Bayesian meta-analysis method, which is more welcome than traditional meta-analysis, has so far not been performed in patients with DKD.
      • This analysis shows that ACEIs and ARBs generally have not dissimilar impacts on renoprotective outcomes.
      • Neither ACEIs nor ARBs can reduce the risk for cardiovascular death or all-cause mortality in DKD.


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        • Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group
        KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.
        Kidney Int Suppl. 2012; 3: 1-150
        • KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 Update
        Am J Kidney Dis. 2012; 60: 850-886
        • Strippoli G.F.
        • Craig M.
        • Deeks J.J.
        • Schena F.P.
        • Craig J.C.
        Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review.
        BMJ. 2004; 329: 828
        • Wang K.
        • Hu J.
        • Luo T.
        • et al.
        Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on All-Cause Mortality and Renal Outcomes in Patients with Diabetes and Albuminuria: a Systematic Review and Meta-Analysis.
        Kidney Blood Press Res. 2018; 43: 768-779
        • Coleman C.I.
        • Weeda E.R.
        • Kharat A.
        • Bookhart B.
        • Baker W.L.
        Impact of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria.
        Diabet Med. 2020; 37: 44-52
        • Strippoli G.F.
        • Bonifati C.
        • Craig M.
        • Navaneethan S.D.
        • Craig J.C.
        Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists for preventing the progression of diabetic kidney disease.
        Cochrane Database Syst Rev. 2006; 2006 (CD006257)
        • Higgins J.P.
        • Altman D.G.
        • Gøtzsche P.C.
        • et al.
        The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.
        BMJ. 2011; 343: d5928
      1. Dias S., Welton N.J., Sutton A.J., Ades A.E.. NICE DSU technical support document 2: A generalised linear modelling framework for pairwise and network meta-analysis of randomised controlled trials, May 2011; last updated September 2016; available from

        • Salanti G.
        • Ades A.E.
        • Ioannidis J.P.
        Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial.
        J Clin Epidemiol. 2011; 64: 163-171
        • Higuchi S.
        • Kohsaka S.
        • Shiraishi Y.
        • et al.
        Association of renin-angiotensin system inhibitors with long-term outcomes in patients with systolic heart failure and moderate-to-severe kidney function impairment.
        Eur J Intern Med. 2019; 62: 58-66