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Review: combination therapy with renin angiotensin inhibitors reduces proteinuria more than single drugs alone in renal disease

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Dr R Kunz

Correspondence to: Dr R Kunz, University Hospital Basel, Switzerland;


In patients with renal disease, do angiotensin receptor blockers (ARBs) reduce proteinuria more than placebo, other antihypertensive drugs, and their combinations?


Studies selected compared ARBs with placebo, ACE inhibitors, or other antihypertensive drugs in patients with renal disease and microalbuminuria or proteinuria. Randomised controlled trials (RCTs) that compared a combination of ARBs and ACE inhibitors with either drug alone were also included. Dose comparison studies or those in patients having renal transplant or with normal urinary protein excretion were excluded. Outcomes included albuminuria or proteinuria (albumin-creatinine or protein-creatinine ratios), and adverse effects.


Medline (1990–September 2006), Cochrane Central Register of Controlled Trials (2006, Issue 3), and reference lists of relevant articles were searched for English …

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  • Source of funding: Santésuisse; the Gottfried and Julia Bangerter-Rhyner Foundation; Novartis.