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Management of Chronic Kidney Disease Stages 1–3

Slide: 17 of 29

Clinical Bottom Line: Risk for Mortality in Patients With CKD Stages 1–3 Treated With ACEIs or ARBs (2 of 2)

Only in a subanalysis of patients with microalbuminuria who had cardiovascular disease or diabetes with other cardiovascular risk factors did ACEI treatment significantly reduce mortality risk when compared with a placebo (ARR = 2.8%; 9.3% vs. 12.1%; RR = 0.79, 95% CI 0.66–0.96; 8 trials, n = 3,440 patients). Relative risk reduction was not significantly different in similar patients who did not have microalbuminuria. Patients who had microalbuminuria and were at high risk for cardiovascular complications may benefit from ACEI treatment at adequate doses.

Abbreviations:
95% CI = 95-percent confidence interval; ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin II receptor blocker; ARR = absolute risk reduction; CKD = chronic kidney disease; RR = relative risk