TABLE 4.

The effects of angiotensin receptor blockers and angiotensin converting enzyme inhibitor combination therapy on the development of cardiovascular disease in pre-dialysis patients with CKD.

Class of RAAS blocker	Authors, Year; Reference number	Patients	Study design	Study protocol	Results
Combination therapy of ACEI and ARB	Torres et al., 2014; 26	N = 486; eGFR 25 < 60 (mL/min/1.73 m2); autosomal dominant polycystic kidney disease	RCT; Multicenter double-blind placebo-controlled clinical trial; Secondary outcomes	Combination of lisinopril and telmisartan compared with lisinopril and placebo (Dose was not shown); 5–8 years	There were no significant differences between the lisinopril–placebo group and the lisinopril–telmisartan group in the rate of hospitalization for cardiovascular disorders (2.30 events per 100 person-years and 1.28 events per 100 person-years, respectively) in patients with CKD.
	Fried et al., 2013; 7	N = 1448; Stage 2–3	RCT; Multicenter double-blind placebo-controlled clinical trial	Losartan 50–100 mg plus lisinopril 10–40 mg a day or losartan 50–100 mg plus placebo; 4 years	There was no significant difference in the rate of cardiovascular events, including myocardial infarction, stroke, and hospitalization for congestive heart failure, between the two groups in patients with CKD (HR, 0.97; 95% CI, 0.76 to 1.23; p = 0.79).

ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; CI, confidence interval; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HR, hazard ratio; RAAS, renin–angiotensin–aldosterone system; RCT, randomized controlled trial