Renin-Angiotensin System Inhibitors for Proteinuria: Monotherapy or Combination Therapy?

Monotherapy with either an ARB or an ACE inhibitor effectively reduces proteinuria; combining the two may pack even more of a punch.

Reduced proteinuria is associated with delayed progression of chronic kidney disease. To explore the comparative effectiveness of angiotensin-receptor blockers (ARBs) in reducing proteinuria, investigators conducted a comprehensive review of 49 randomized trials. The analysis involved a total of 6181 participants in 72 comparisons with 1 to 4 months of follow-up and in 38 comparisons with 5 to 12 months of follow-up. ARBs were compared with placebo in 12 studies, with calcium channel blockers in 9 studies, with ACE inhibitors in 23 studies, and with combinations of an ARB and an ACE inhibitor in 16 studies. In 23 trials, combination ARB plus ACE-inhibitor treatment was compared with ACE inhibitors alone.

Compared with placebo, ARBs were asso…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Renin-Angiotensin System Inhibitors for Proteinuria: Monotherapy or Combination Therapy?

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Reviewing Author