scholarly journals Comparative efficacy of different renin angiotensin system blockade therapies in patients with IgA nephropathy: a Bayesian network meta-analysis of 17 RCTs

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11661
Author(s):  
Zhihao Huo ◽  
Huizhen Ye ◽  
Peiyi Ye ◽  
Guanqing Xiao ◽  
Zhe Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Network Analysis ◽  
Bayesian Network ◽  
Iga Nephropathy ◽  
Kidney Function ◽  
Meta Analysis ◽  
Renin Angiotensin System ◽  
Cochrane Library ◽  
Angiotensin System ◽  
Renin Angiotensin

Background IgA nephropathy (IgAN) is still one of the most prevalent forms of primary glomerulonephritis globally. However, no guidelines have clearly indicated which kinds of renin angiotensin system blockade therapies (ACEIs or ARBs or their combination) in patients with IgAN result in a greater reduction in proteinuria and a better preservation of kidney function. Thus, we conducted a Bayesian network analysis to evaluate the relative effects of these three therapy regimens in patients with IgAN. Methods The protocol was registered in PROSPERO with ID CRD42017073726. We comprehensively searched the PubMed, the Cochrane Library, Embase, China Biology Medicine disc, WanFang and CNKI databases for studies published since 1993 as well as some grey literature according to PICOS strategies. Pairwise meta-analysis and Bayesian network analysis were conducted to evaluate the effect of different regimens. Results Seventeen randomized controlled trials (RCTs) involving 1,006 patients were analyzed. Co-administration of ACEIs and ARBs had the highest probability (92%) of being the most effective therapy for reducing proteinuria and blood pressure, but ACEIs would be the most appropriate choice for protecting kidney function in IgAN. Conclusion The combination of ACEIs and ARBs seems to have a significantly better antiproteinuric effect and a greater reduction of blood pressure than ACEI or ARB monotherapy in IgAN. ACEIs appear to be a more renoprotective therapy regimen among three therapies.

scholarly journals Use of inhibitors of the renin angiotensin system and COVID-19 prognosis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Jessica Barochiner ◽  
Rocio Martinez
Keyword(s):  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Random Effect ◽  
Renin Angiotensin System ◽  
Cochrane Library ◽  
Composite Outcome ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Ras Inhibitors

Background: controversy has arisen in the scientific community on whether the use of renin angiotensin system (RAS) inhibitors in the context of COVID-19 would be of benefit or harmful. A meta-analysis of eligible studies comparing the occurrence of severe and fatal COVID-19 in infected patients who were under treatment with angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) vs no treatment or other antihypertensives was conducted. Methods: PubMed, Google Scholar, the Cochrane Library, MedRxiv and BioRxiv were searched for relevant studies. Fixed-effect models or random-effect models were used depending on the heterogeneity between estimates. Results: a total of fifteen studies with 21,614 patients were included. The use of RAS inhibitors was associated with a non-significant 20% decreased risk of the composite outcome (death, admission to intensive care unit, mechanical ventilation requirement or progression to severe or critical pneumonia): RR 0.81 (95%CI: 0.63-1.04), p=0.10, I2=82%. In a subgroup analysis that included hypertensive subjects only, ACEI/ARB were associated with a 27% significant decrease in the risk of the composite outcome (RR 0.73 (95%CI: 0.56-0.96), p=0.02, I2=65%). Conclusion: the results of this pooled analysis suggest that the use of ACEI/ARB does not worsen the prognosis, and could even be protective in hypertensive subjects. Patients should continue these drugs during their COVID-19 illness.

Effects of Nitrendipine on Blood Pressure, Renin-Angiotensin System, and Kidney Function in Essential Hypertension

1988 ◽  
Vol 12 ◽  
pp. S142-S145 ◽  
Author(s):  
Nicola Glorioso ◽  
Paolo Manunta ◽  
Chiara Troffsa ◽  
Antonio Pazzola ◽  
Aldo Soro ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Kidney Function ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Renin Angiotensin
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