Summary of findings 3. Angiotensin receptor blockers (ARBs) versus angiotensin‐converting enzyme inhibitors (ACEis) for preserving residual kidney function in peritoneal dialysis patients.
| ARBs compared with ACEis for preserving residual kidney function in peritoneal dialysis patients | ||||||
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Patient or population: patients receiving PD Settings: outpatient Intervention: ARB Comparison: ACEi | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| ACEi | ARB | |||||
| Residual kidney function (4 weeks) | Mean across ACEi group was 2.28 mL/min/1.73 m² | Mean was 0.47 mL/min/1.73 m² lower (95% Cl ‐2.73 to 1.79) in the ARB group | 20 (1) | ⊕⊕⊝⊝ low | ||
| Residual kidney function (12 months) | Mean across ACEi group was 2.36 mL/min/1.73 m² | Mean was 0.18 mL/min/1.73 m² higher (95% Cl ‐0.04 to 0.40) in the ARB group | 60 (1) | ⊕⊕⊕⊝ moderate | ||
| Anuria |
High risk population 367 per 1000 |
400 per 1000 | RR 1.15 (0.41 to 3.26) | 60 (1) | ⊕⊕⊕⊝ moderate | |
| Cardiovascular events (non‐fatal) |
High risk population 100 per 1000 |
133 per 1000 | RR 1.33 (0.33 to 5.45) | 60 (1) | ⊕⊕⊕⊝ moderate | |
| Serum potassium | Mean across ACEi group was 4.42 mmol/L | Mean was 0.05 mmol/L lower (95% Cl ‐2.73 to 1.79) in the ARB group | 42 (1) | ⊕⊕⊕⊝ moderate | ||
| Systolic BP | Mean across ACEi group was 141.95 mm Hg | Mean was 0.48 mm Hg higher (95% Cl ‐7.76 to 8.72) in the ARB group | 42 (1) | ⊕⊕⊕⊝ moderate | ||
| Diastolic BP | Mean across ACEi group was 84.19 mm Hg | Mean was 0.38 mm Hg higher (95% Cl ‐6.76 to 7.52) in the ARB group | 42 (1) | ⊕⊕⊕⊝ moderate | ||
| Cough |
High risk population 67 per 1000 |
100 per 1000 |
RR 1.56 (0.24 to 10.05) |
60 (1) | ⊕⊕⊕⊝ moderate | |
| Hyperkalaemia |
High risk population 69 per 1000 |
83 per 1000 | RR 1.23 (0.35 to 4.40) | 144 (2) | ⊕⊕⊕⊝ moderate | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||