Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD), impaired quality of life and all-cause mortality.

ACE inhibitors (ACEIs) and angiotensin II receptor blockers(ARBs) provide significant renal and cardiovascular protection for CKD patients, but the efficacy and safety of these agents in non-dialysis CKD3–5 patients is still uncertain.

This network meta-analysis demonstrates that ACEIs are superior to ARBs and other antihypertensive agents in reducing adverse cardiovascular and renal events, and all-cause mortality in non-dialysis CKD 3–5 patients, and are also superior to ARBs in lowering odds of all-cause death but not in kidney events and cardiovascular events in the subgroup of patients with advanced CKD.