Key result
The use of ACEI (MD -0.75), ARB (MD -0.56), or their combination (MD -0.63) significantly reduced proteinuria levels in patients with IgA nephropathy compared to control.
Why the study?
ACEI and ARB are widely used in patients with IgA nephropathy, but their clinical effects remain controversial.
Does ACEI and/or ARB reduce proteinuria and improve renal function in patients with IgA nephropathy?
Meta-Analysis (n=635)
Does ACEI and/or ARB reduce proteinuria and improve renal function in patients with IgA nephropathy?
Mean Difference: -0.75 (95% CI -1.28–-0.21)
p-value: p=0.006
ACEI and ARB significantly reduce proteinuria in patients with IgA nephropathy, though this meta-analysis did not show a significant effect on serum creatinine or glomerular filtration rate.
Reduces proteinuria in IgAN; reinforces RAAS blockade as standard while underscoring need for long-term outcome RCTs.
BACKGROUND: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) as the commonly used renin-angiotensin aldosterone system inhibitor are widely used in patients with IgA nephropathy (IgAN), but the effect is controversy. In this study, we used a meta-analysis to evaluate the efficacy and safety of ACEI and/or ARB for the patients with IgAN. METHODS: Two investigators independently searched the PubMed, EMBASE, the Cochrane Library, EBSCO, and Wiley databases without language restrictions. We collected the clinical randomized controlled trials (RCTs) on "ACEI and/or ARB for the patients with IgAN" published before December 31, 2018, and performed data extraction and quality analysis on the included studies, and analyzed data using RevMan 5.2 software. RESULTS: <0.001) significantly reduced the levels of proteinuria in patients with IgAN. However, whether using ACEI or ARB alone or in combination with ACEI and ARB, there was no significant effect on serum creatinine, 24-creatinine clearance and glomerular filtration rate in patients with IgAN. CONCLUSION: The use of ACEI and ARB significantly reduces the levels of proteinuria in patients with IgAN, but more large-sample RCTs with long-term follow-up are needed for confirming our results and guiding clinical treatment.
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Zhao et al. (2020) conducted a meta-analysis in IgA nephropathy (n=635). Renin-Angiotensin Aldosterone System Inhibitor (ACEI and/or ARB) vs. Placebo or control group was evaluated on Proteinuria levels (ACEI alone vs control) (MD -0.75, 95% CI -1.28 to -0.21, p=0.006). The use of ACEI (MD -0.75), ARB (MD -0.56), or their combination (MD -0.63) significantly reduced proteinuria levels in patients with IgA nephropathy compared to control.
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