A system review: the effects of T-type CCB or ACEI /ARB for hypertensive patients with chronic kidney disease / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate whether T-type CCBs are equivalent with or superior to ACEIs/ARBs on renal outcomes in hupertensive patients with chronic kidney disease. METHODS: Cochrane Library, Pubmed, EMbase and CNKI were searched for relevant randomized controlled trials (RCTs) from inception to May 2012. The meta-analysis was performed by Revman 5.1 software. RESULTS: Five RCTs (563 subjects) were included in the present study. T-type CCBs performed a pooled improvement in creatinine clearance and glomerular filtration rate similar to ACEIs/ARBs but were inferior to ACEIs/ARBs on reducing proteinuria excretion (three RCTs, 389 subjects, WMD 0.26 g·d-1, 95% CI 0.10 to 0.43), although T-type CCBs and ACEIs/ARBs showed stable anti-hypertensive effect. CONCLUSION: Our findings suggest that despite T-type CCBs do offer salutary effects on kidney outcomes and hypertension can be applied to treat hypertensive patients with chronic kidney disease, ACEIs /ARBs might be better choice for pressure control in this target population especially when proteinuria is the main issue of renal dysfunction.