16% decrease in reciprocal creatinine in placebo group at seven years ( P <. No change in either group over 12 weeks not statistically evaluatedĤ2% ARR for development of macroalbuminuria with enalapril vs. increase with placebo (30.6 to 39.0 mg per dL P <. No change with ramipril (29.5 to 27.7 mg per dL) vs. 13% decrease in reciprocal creatinine in placebo group at five years ( P <. No difference in either group over 48 monthsģ0% ARR for development of macroalbuminuria with enalapril vs. increase with placebo (93.9 to 150.0 mg per dL no P value given) over 48 months Reduction with enalapril (115.4 to 75.3 mg per dL P <. no change with vitamin B 12 over six months (104.7 to 103.9 mg per dL P <. Reduction with losartan (101.9 to 47.5 mg per dL) vs. The authors of this meta-analysis and several of the referenced studies received funding from industry.Įffect on 24-hour urinary albumin excretion Changes in estimated creatinine clearance and glomerular filtration rate were not reported. Regression to normal albuminuria occurred more often with ACE inhibitors than with placebo (OR = 3.07 95% CI, 2.14 to 4.44). Nine of the 10 trials demonstrated a significantly lower risk of progression to macroalbuminuria with ACE inhibitors compared with placebo (odds ratio = 0.38 95% confidence interval, 0.25 to 0.57).
Two-year follow-up data were available for 646 patients. 1 Several definitions of normotension were allowed microalbuminuria was defined as a urinary albumin excretion rate of 20 to 200 mcg per minute, whereas a rate greater than 200 mcg per minute was considered macroalbuminuria. placebo on progression to macro-albuminuria in normotensive patients with microalbuminuria and type 1 diabetes.
A 2001 meta-analysis of 10 small RCTs (N = 698) described the effect of ACE inhibitors vs.
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