Management of Chronic Kidney Disease Stages 1–3
Conclusions: Treatment (1 of 2)
In patients with CKD stages 1–3 who have overt proteinuria (macroalbuminuria) with concomitant diabetes and hypertension, an ACEI or an ARB will reduce the risk of ESRD. In patients with CKD stages 1–3 with only microalbuminuria or impaired eGFR, ACEIs did not reduce the risk for ESRD when compared with a placebo, but these trials were not powered to detect a difference. There was no increased benefit for reducing the risk of ESRD if an ACEI and an ARB were taken as combination therapy when compared with taking either an ACEI or an ARB alone. Taking an ACEI or an ARB did not reduce the risk of mortality, except when an ACEI was used for patients with microalbuminuria and cardiovascular disease or diabetes and other cardiovascular risk factors.
ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin II receptor blocker; CKD = chronic kidney disease; ESRD = end-stage renal disease
- Fink HA, Ishani A, Taylor BC, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review No. 37 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC075-EF. Available at www.effectivehealthcare.ahrq.gov/ckd.cfm.
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