Why the study?
Does combination therapy with an ACE inhibitor and an ARB reduce 24-h urinary protein excretion in patients with diabetic nephropathy compared to ACE inhibitor alone?
Population
10 trials pooling 315 patients with diabetic nephropathy
Comparison
Combination therapy with an ACE inhibitor and an… vs ACE inhibitor (ACEI) alone
Design
Meta-analysis
Follow-up
8-12 weeks (most studies)
Authors
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Warrants caution with dual blockade despite proteinuria benefit; heterogeneity and adverse GFR/potassium effects leave long-term role open.
Does combination therapy with an ACE inhibitor and an ARB reduce 24-h urinary protein excretion in patients with diabetic nephropathy compared to ACE inhibitor alone?
Combination ACEI and ARB therapy reduces proteinuria more than ACEI alone in diabetic nephropathy but is associated with adverse effects on GFR and potassium, with uncertain long-term benefits.
Jennings et al. (2007) studied this question.
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