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Effects of ACEIs and ARBs on the Residual Renal Function in Peritoneal Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials.
Biomed Res Int. 2020; 2020:6762029.BR

Abstract

Background

In peritoneal dialysis (PD) patients, whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could protect residual renal function is still controversial. To assess the effects of ACEIs and ARBs on the residual renal function and cardiovascular (CV) events in peritoneal dialysis patients, we performed a meta-analysis of randomized controlled trials.

Materials and Methods

We searched PubMed, EMBASE, the Cochrane Library, the CNKI database, and the Wanfang database for relevant articles from database inception to November 30, 2019. Randomized controlled trials were included. The primary outcome was the decline in the residual renal function (RRF).

Results

Thirteen trials with 625 participants were included in the meta-analysis. The average residual GFR declined by 1.79 ml/min per 1.73 m2 in the ACEI/ARB group versus 1.44 ml/min per 1.73 m2 in the placebo or active control group at 3 mo. The average residual GFR declined by 2.02 versus 2.06, 2.16 versus 2.72, and -0.04 versus 2.74 ml/min per 1.73 m2 in the placebo or active control group at 6 months (mo), 12 mo, and 24 mo, respectively. The decline in residual GFR showed a significant difference between the ACEI/ARB group and the placebo or active control group at 12 mo (MD = -0.64 ml/min per 1.73 m2; 95% CI: -0.97~-0.32; I 2 = 44%; P < 0.0001). No significant difference was observed in Kt/V, urinary protein excretion, weekly creatinine clearance, CV events, or serum potassium levels.

Conclusions

In the present study, we found that the use of ACEIs and ARBs, especially long-term treatment, decreased the decline of RRF in patients on PD. ACEIs and ARBs do not cause an additional risk of side effects.

Authors+Show Affiliations

Department of Nephrology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, N1 Shangcheng Road, Yiwu, Zhejiang, China.Department of Nephrology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, N1 Shangcheng Road, Yiwu, Zhejiang, China.Department of Nephrology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, N1 Shangcheng Road, Yiwu, Zhejiang, China.Department of Nephrology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, N1 Shangcheng Road, Yiwu, Zhejiang, China.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

33029520

Citation

Ding, Lei, et al. "Effects of ACEIs and ARBs On the Residual Renal Function in Peritoneal Dialysis Patients: a Meta-Analysis of Randomized Controlled Trials." BioMed Research International, vol. 2020, 2020, p. 6762029.
Ding L, Yang J, Li L, et al. Effects of ACEIs and ARBs on the Residual Renal Function in Peritoneal Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2020;2020:6762029.
Ding, L., Yang, J., Li, L., & Yang, Y. (2020). Effects of ACEIs and ARBs on the Residual Renal Function in Peritoneal Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials. BioMed Research International, 2020, 6762029. https://doi.org/10.1155/2020/6762029
Ding L, et al. Effects of ACEIs and ARBs On the Residual Renal Function in Peritoneal Dialysis Patients: a Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2020;2020:6762029. PubMed PMID: 33029520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of ACEIs and ARBs on the Residual Renal Function in Peritoneal Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials. AU - Ding,Lei, AU - Yang,Jingjuan, AU - Li,Lizhu, AU - Yang,Yi, Y1 - 2020/09/23/ PY - 2020/04/27/received PY - 2020/08/21/accepted PY - 2020/10/8/entrez PY - 2020/10/9/pubmed PY - 2021/5/13/medline SP - 6762029 EP - 6762029 JF - BioMed research international JO - Biomed Res Int VL - 2020 N2 - Background: In peritoneal dialysis (PD) patients, whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could protect residual renal function is still controversial. To assess the effects of ACEIs and ARBs on the residual renal function and cardiovascular (CV) events in peritoneal dialysis patients, we performed a meta-analysis of randomized controlled trials. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library, the CNKI database, and the Wanfang database for relevant articles from database inception to November 30, 2019. Randomized controlled trials were included. The primary outcome was the decline in the residual renal function (RRF). Results: Thirteen trials with 625 participants were included in the meta-analysis. The average residual GFR declined by 1.79 ml/min per 1.73 m2 in the ACEI/ARB group versus 1.44 ml/min per 1.73 m2 in the placebo or active control group at 3 mo. The average residual GFR declined by 2.02 versus 2.06, 2.16 versus 2.72, and -0.04 versus 2.74 ml/min per 1.73 m2 in the placebo or active control group at 6 months (mo), 12 mo, and 24 mo, respectively. The decline in residual GFR showed a significant difference between the ACEI/ARB group and the placebo or active control group at 12 mo (MD = -0.64 ml/min per 1.73 m2; 95% CI: -0.97~-0.32; I 2 = 44%; P < 0.0001). No significant difference was observed in Kt/V, urinary protein excretion, weekly creatinine clearance, CV events, or serum potassium levels. Conclusions: In the present study, we found that the use of ACEIs and ARBs, especially long-term treatment, decreased the decline of RRF in patients on PD. ACEIs and ARBs do not cause an additional risk of side effects. SN - 2314-6141 UR - https://www.unboundmedicine.com/medline/citation/33029520/Effects_of_ACEIs_and_ARBs_on_the_Residual_Renal_Function_in_Peritoneal_Dialysis_Patients:_A_Meta_Analysis_of_Randomized_Controlled_Trials_ L2 - https://doi.org/10.1155/2020/6762029 DB - PRIME DP - Unbound Medicine ER -