Key result
Triple RAAS blockade is linked to ~27% lower 24-hour urinary protein excretion versus double blockade.
Why the study?
Does triple RAAS blockade reduce proteinuria in patients with non-diabetic chronic kidney disease compared to single or double blockade?
Observational (n=589)
No
Does triple RAAS blockade reduce proteinuria in patients with non-diabetic chronic kidney disease compared to single or double blockade?
Absolute Event Rate: 526.17% vs 716.54%
p-value: p=0.0160
Triple RAAS blockade with ramipril, telmisartan, and eplerenone significantly reduces proteinuria in non-diabetic chronic kidney disease compared to single or double blockade.
May reduce proteinuria in non-diabetic CKD; hypothesis-generating and should not yet change practice.
Background: Although dual blockade of the renin-angiotensin-aldosterone system with the combination of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker is generally well established as a treatment for nephropathy, this treatment is not fully effective in some patients.Methods: A prospective observational study was done on 600 chronic kidney disease patients during July 2012 to August 2014 to compare the efficacy of triple blockade, double blockade and single blockade of renin-angiotensin-aldosterone system in non diabetic chronic kidney disease.Results: At the end of the study, 24 hours urinary protein excretion rate of group I and group III were compared by using student t-test and p value (0.0268) was found significant. Similarly, on comparing group II and group III, p value (0.0160) was again found significant.Conclusions: Triple blockade of the renin-angiotensin-aldosterone system was effective for the treatment of proteinuria in patients with non-diabetic nephropathy whose increased urinary protein had not responded sufficiently to a dual blockade.
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Gupta et al. (2018) conducted an observational in Non-diabetic chronic kidney disease (n=589). Triple blockade (Ramipril + Telmisartan + Eplerenone) vs. Double blockade (Ramipril + Telmisartan) and Single blockade (Ramipril) was evaluated on 24 hours urinary protein excretion (mg/24 hrs) (p=0.0160).
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