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ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials.
Int J Clin Pract. 2009 Jun; 63(6):880-8.IJ

Abstract

BACKGROUND

Published reports examining the efficacy of RAS blockers: angiotensin converting-enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) agents for preserving renal function in IgA nephropathy (IgAN) have yielded conflicting results. To evaluate systematically the effects of ACEI/ARB agents on IgAN, we conducted a meta analysis of published randomised controlled trials (RCTs).

METHODS

MEDLINE, EMBASE, the Cochrane Library and article reference lists were searched for RCTs that compared ACEI/ARB with placebo and any other antihypertensive agents or non-immunosuppressive agents for treating IgAN. The quality of the studies was evaluated with the method of intention to treat analysis and allocation concealment, as well as with the Jadad method. Meta analyses were performed on the outcomes of proteinuria and renal function in patients with IgAN.

RESULTS

Eleven RCTs involving 585 patients were included in the review. Seven trials used placebo/no treatment as controls. Four trials used other antihypertensive agents as controls. Overall, ACEI/ARB agents had statistically significant effects on protecting renal function(p < 0.00001) and reduction of proteinuria (p < 0.00001) when compared with control group. Tests for heterogeneity showed no difference in effect among the studies. Systolic and diastolic blood pressure, glomerular filtration rate (GFR), age, did not influence treatment response. ACEI/ARB agents were well tolerated.

CONCLUSIONS

The current cumulative evidence suggests that ACEI/ARB agents had statistically significant effects on protecting renal function and reduction of proteinuria in patients with IgAN when compared with control groups. ACEI/ ARB agents are a promising medication and should be investigated further.

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Authors+Show Affiliations

Cheng J
Kidney Disease Center of the First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China.
Zhang W
No affiliation info available
Zhang XH
No affiliation info available
He Q
No affiliation info available
Tao XJ
No affiliation info available
Chen JH
No affiliation info available

MeSH

Angiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBlood PressureCreatinineGlomerulonephritis, IGAHumansProteinuriaPublication BiasRandomized Controlled Trials as Topic

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

19490198

Citation

Cheng, J, et al. "ACEI/ARB Therapy for IgA Nephropathy: a Meta Analysis of Randomised Controlled Trials." International Journal of Clinical Practice, vol. 63, no. 6, 2009, pp. 880-8.
Cheng J, Zhang W, Zhang XH, et al. ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. Int J Clin Pract. 2009;63(6):880-8.
Cheng, J., Zhang, W., Zhang, X. H., He, Q., Tao, X. J., & Chen, J. H. (2009). ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. International Journal of Clinical Practice, 63(6), 880-8. https://doi.org/10.1111/j.1742-1241.2009.02038.x
Cheng J, et al. ACEI/ARB Therapy for IgA Nephropathy: a Meta Analysis of Randomised Controlled Trials. Int J Clin Pract. 2009;63(6):880-8. PubMed PMID: 19490198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. AU - Cheng,J, AU - Zhang,W, AU - Zhang,X H, AU - He,Q, AU - Tao,X J, AU - Chen,J H, PY - 2009/6/4/entrez PY - 2009/6/6/pubmed PY - 2010/11/3/medline SP - 880 EP - 8 JF - International journal of clinical practice JO - Int J Clin Pract VL - 63 IS - 6 N2 - BACKGROUND: Published reports examining the efficacy of RAS blockers: angiotensin converting-enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) agents for preserving renal function in IgA nephropathy (IgAN) have yielded conflicting results. To evaluate systematically the effects of ACEI/ARB agents on IgAN, we conducted a meta analysis of published randomised controlled trials (RCTs). METHODS: MEDLINE, EMBASE, the Cochrane Library and article reference lists were searched for RCTs that compared ACEI/ARB with placebo and any other antihypertensive agents or non-immunosuppressive agents for treating IgAN. The quality of the studies was evaluated with the method of intention to treat analysis and allocation concealment, as well as with the Jadad method. Meta analyses were performed on the outcomes of proteinuria and renal function in patients with IgAN. RESULTS: Eleven RCTs involving 585 patients were included in the review. Seven trials used placebo/no treatment as controls. Four trials used other antihypertensive agents as controls. Overall, ACEI/ARB agents had statistically significant effects on protecting renal function(p < 0.00001) and reduction of proteinuria (p < 0.00001) when compared with control group. Tests for heterogeneity showed no difference in effect among the studies. Systolic and diastolic blood pressure, glomerular filtration rate (GFR), age, did not influence treatment response. ACEI/ARB agents were well tolerated. CONCLUSIONS: The current cumulative evidence suggests that ACEI/ARB agents had statistically significant effects on protecting renal function and reduction of proteinuria in patients with IgAN when compared with control groups. ACEI/ ARB agents are a promising medication and should be investigated further. SN - 1742-1241 UR - https://www.unboundmedicine.com/medline/citation/19490198/ACEI/ARB_therapy_for_IgA_nephropathy:_a_meta_analysis_of_randomised_controlled_trials_ L2 - https://doi.org/10.1111/j.1742-1241.2009.02038.x DB - PRIME DP - Unbound Medicine ER -