当前位置: X-MOL 学术J. Endocrinol. Investig. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Effects of renin-angiotensin system blockers on renal and cardiovascular outcomes in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials.
Journal of Endocrinological Investigation ( IF 5.4 ) Pub Date : 2020-01-14 , DOI: 10.1007/s40618-020-01179-8
X Liu 1 , L Ma 2 , Z Li 1
Affiliation  

PURPOSE This study aimed to evaluate the effect f angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on renal or cardiovascular outcomes in patients with diabetic nephropathy (DN). METHODS PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) evaluating the treatment effects of ACEI and ARB on renal or cardiovascular outcomes in patients with DN until August 2017. The outcomes included end-stage renal disease (ESRD), doubling of serum creatinine levels, all-cause mortality, major cardiovascular events (MACEs), myocardial infarction (MI), stroke, and cardiac death. Relative risks (RR) with 95% confidence intervals (CIs) were used for calculating the summary results using a random-effects model. RESULTS Twenty-four RCTs including 57,818 patients with DN and 891 events of ESRD, 1050 doubling of serum creatinine concentration, 4352 all-cause mortality, 6342 MACEs, 1073 MI, 2900 stroke, and 1674 cardiac deaths were reported. Overall, the summary results suggested that in patients with DN, receiving ACEI did not have a significant effect on ESRD, doubling of serum creatinine levels, all-cause mortality, MI, stroke, and cardiac death, while ACEI significantly reduced the risk of total MACEs. Furthermore, ARB therapy was associated with a low risk of ESRD and doubling of serum creatinine levels, while it did not differ significantly on all-cause mortality, MACEs, MI, stroke, and cardiac death in patients with DN. CONCLUSIONS Patients with DN receiving ACEI had significantly reduced the risk of total MACEs, and ARB could reduce the incidence of ESRD and the doubling of serum creatinine levels.

中文翻译:

肾素-血管紧张素系统阻滞剂对糖尿病肾病患者肾脏和心血管预后的影响:一项随机对照试验的荟萃分析。

目的本研究旨在评估血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB)对糖尿病肾病(DN)患者肾脏或心血管结局的影响。方法搜寻PubMed,Embase和Cochrane库以评估ACEI和ARB对DN患者的肾或心血管结局的治疗效果的随机对照试验(RCT),直至2017年8月。结果包括终末期肾病(ESRD),血清肌酐水平增加一倍,全因死亡率,主要心血管事件(MACE),心肌梗塞(MI),中风和心源性死亡。具有95%置信区间(CI)的相对风险(RR)用于使用随机效应模型计算汇总结果。结果二十四项RCT包括57项,据报道,有818例DN患者和891例ESRD事件,1050例血肌酐浓度升高一倍,4352例全因死亡率,6342个MACE,1073 MI,2900例卒中和1674例心源性死亡。总体而言,总结结果表明,接受DNEI治疗的DN患者对ESRD没有明显影响,血清肌酐水平加倍,全因死亡率,MI,中风和心源性死亡均显着增加,而ACEI则显着降低了总风险MACE。此外,ARB治疗与ESRD的低风险和血清肌酐水平加倍相关,而在DN患者的全因死亡率,MACE,MI,中风和心源性死亡方面无显着差异。结论接受ACEI的DN患者明显降低了发生总MACE的风险,
更新日期:2020-01-15
down
wechat
bug