{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T22:53:55Z","timestamp":1788216835592,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T00:00:00Z","timestamp":1566432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the impact of angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature search up to 6 June 2019 was performed. We included randomized trials of \u2265100 participants with Type 2 diabetes and micro\u2010 or macroalbuminuria comparing an angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker with placebo \u00b1 background anti\u2010hypertensives or non\u2010angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker\u2010containing anti\u2010hypertensives, which included follow\u2010up of \u226512 months. Endpoints included doubling of serum creatinine, end\u2010stage renal disease, all\u2010cause and cardiovascular mortality and progression and regression of proteinuria. A Hartung\u2010Knapp random\u2010effects model (between\u2010study variance calculated using the Paule\u2010Mandel estimator) producing a risk ratio with 95% confidence interval was employed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The use of an angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker was not associated with a significant reduction in the risk of a doubling in serum creatinine (n = 7 trials, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 0.77, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.50\u20131.21). Angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers reduced the risk of progressing to end\u2010stage renal disease (n = 8, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 0.79, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.75\u20130.83). No difference in all\u2010cause (n = 11, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 0.98, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.89\u20131.08) or cardiovascular mortality (n = 6 trials, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 1.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.92\u20131.28), nor the composite outcome of doubling in serum creatinine, end\u2010stage renal disease or mortality (n = 3 trials, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 0.87, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.72\u20131.06), was observed. Progression of proteinuria was decreased with angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker use vs. control (n = 10, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 0.49, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.33\u20130.74). Regression of proteinuria was not improved with an angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker (n = 11, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> = 1.55, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.93\u20132.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers may reduce the risk of end\u2010stage renal disease and slow the progression of nephropathy, but they do not appear to decrease all\u2010cause or cardiovascular mortality in people with Type 2 diabetes and proteinuria.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14107","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T06:10:17Z","timestamp":1565676617000},"page":"44-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4868-7158","authenticated-orcid":false,"given":"C. I.","family":"Coleman","sequence":"first","affiliation":[{"name":"University of Connecticut School of Pharmacy Storrs CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. R.","family":"Weeda","sequence":"additional","affiliation":[{"name":"College of Pharmacy at the Medical University of South Carolina Charleston SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kharat","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Bookhart","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC Titusville NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. L.","family":"Baker","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Pharmacy Storrs CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.02.023"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910073411506"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/10641969909061018"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/1056-8727(95)80036-E"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-2-199301150-00009"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S009"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38237.585000.7C"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.10.011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62459-4"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1009"},{"key":"e_1_2_6_14_1","unstructured":"SchwarzerG.Package \u2018meta\u2019: general package for meta\u2010analysis. 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