A systematic review of efficacy and safety for calcium channel blockers in the treatment of albuminuria in patients with diabetes and hypertension

Devanshu J. Patel; Uzma Noor Shah; Shilpa Reddy Ganta; T. Aneesh John

doi:10.31893/multirev.2023ss004

Keywords:

Calcium Channel Blockers (CCB)

Albuminuria

Diabetes

Hypertension and Cardiovascular diseases (CVD)

Blood pressure (BP)

Abstract

In individuals with diabetes mellitus (DM) and hypertension, renin-angiotensin system (RAS) inhibitors are advised for the therapy of albuminuria, although there is limited agreement on other treatments. Calcium channel blockers (CCB) are often used for hypertension patients, their effectiveness in those with albuminuria remains uncertain. Patients with diabetes, hypertension and nephropathy were evaluated for their response to CCB and inhibitors of the RAS to reduce albuminuria. We measured albuminuria before and after the intervention and compared CCB to RAS inhibitors by looking through records on MEDLINE, Embase and CENTRAL. Randomized controlled adult trials were identified using abstract screening were performed separately. 20 papers were selected from 800 records using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We evaluated data from 2,114 participants in the experiment who had the equivalent of pre-hypertension and diabetic mellitus of ≥31 days/mg of urine albumin excretion. The standardized mean difference in reducing albuminuria was 0.443. When analyzing the treatment impact on blood pressure, the research showed no significant difference between RAS inhibitors and CCB in terms of indications of renal function. RAS inhibitors could be superior to CCB in reducing albuminuria in hypertensive and diabetic nephropathy.
References
1. Adachi H, Kakuma T, Kawaguchi M, Kumagai E & Fukumoto Y, KES Study Investigators (2019). Effects of eplerenone on BP and glucose metabolism in Japanese hypertensives with overweight or obesity. Medicine, 98(15), e14994. DOI: 10.1097/MD.0000000000014994.
2. Arnold JT, Lloyd AB, Bailey SJ, Fujimoto T, Matsutake R, Takayanagi M, Nishiyama T & Fujii N (2020). The nitric oxide dependence of cutaneous microvascular function to independent and combined hypoxic cold exposure. Journal of Applied Physiology, 129(4), 947-56. DOI: 10.1152/japplphysiol.00487.2020.
3. Arvanitis M, Qi G, Bhatt DL, Post WS, Chatterjee N, Battle A & McEvoy JW (2021). Linear and nonlinear Mendelian randomization analyses of the association between diastolic BP and cardiovascular events: the J-curve revisited. Circulation, 143(9), 895-906. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.049819.
4. Brady TM, Charleston J, Ishigami J, Miller III ER, Matsushita K & Appel LJ (2021). Effects of different rest period durations prior to BP measurement: the best rest trial. Hypertension, 78(5), 1511-9.DOI: 10.1161/HYPERTENSIONAHA.121.17496.
5. Brandt-Jacobsen NH, Johansen ML, Rasmussen J, Forman JL, Holm MR, Faber J, Rossignol P, Schou M & Kistorp C (2021). Effect of high-dose mineralocorticoid receptor antagonist eplerenone on urinary albumin excretion in patients with type 2 diabetes and high cardiovascular risk: data from the MIRAD trial. Diabetes & metabolism, 47(4), 101190. DOI: 10.1016/j.diabet.2020.08.005.
6. Cativo EH, Lopez PD, Cativo DP, Atlas SA & Rosendorff C (2021). The effect of calcium channel blockers on moderate or severe albuminuria in diabetic, hypertensive patients. The American Journal of Medicine, 134(1), 104-13. DOI: 10.1016/j.amjmed.2020.05.039.
7. Chung EY, Ruospo M, Natale P, Bolignano D, Navaneethan SD, Palmer SC & Strippoli GF (2020). Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD007004.pub4.
8. Coresh J, Heerspink HJ, Sang Y, Matsushita K, Arnlov J, Astor BC, Black C, Brunskill NJ, Carrero JJ, Feldman HI & Fox CS (2019). Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies. The lancet Diabetes & endocrinology, 7(2), 115-27. DOI: https://doi.org/10.1016/S2213-8587(18)30313-9.
9. Fici F, Ari Bakir E, IlkayYüce E, Kanuncu S, Makel W, Tarim BA & Robles NR (2020). PAIT-Survey Follow-Up: Changes in Albuminuria in Hypertensive Diabetic Patients with Mild-Moderate Chronic Kidney Disease. High BP & Cardiovascular Prevention, 27, 43-9. DOI: 10.1007/s40292-020-00358-1.
10. Fu EL, Clase CM, Evans M, Lindholm B, Rotmans JI, Dekker FW, van Diepen M & Carrero JJ (2021). Comparative effectiveness of RASinhibitors and calcium channel blockers in individuals with advanced CKD: a nationwide observational cohort study. American Journal of Kidney Diseases, 77(5), 719-29. DOI: 10.1053/j.ajkd.2020.10.006.
11. Fulton EA, McBrearty AR, Shaw DJ & Ridyard AE (2023). Response and survival of dogs with proteinuria (UPC> 2.0) treated with angiotensin converting enzyme inhibitors. Journal of Veterinary Internal Medicine. DOI:10.1111/jvim.16864.
12. Gallo G, Volpe M & Rubattu S (2022). Angiotensin receptor blockers in the management of hypertension: a real-world perspective and current recommendations. Vascular Health and Risk Management, 507-15. DOI: https://doi.org/10.2147/VHRM.S337640.
13. Jeong HS, Lim HS, Park HJ, Lee WS, Choi JO, Lee HS, Jo SH & Hong SJ (2021). Clinical outcomes between calcium channel blockers and angiotensin receptor blockers in hypertensive patients without established cardiovascular diseases during a 3-year follow-up. Scientific Reports, 11(1), 1783. DOI: 10.1038/s41598-021-81373-7.
14. Kawanami D, Takashi Y, Muta Y, Oda N, Nagata D, Takahashi H & Tanabe M (2021). Mineralocorticoid receptor antagonists in diabetic kidney disease. Frontiers in Pharmacology, 12, 754239. DOI: 10.3389/fphar.2021.754239.
15. Khan MS, Shahid I, Anker SD, Fonarow GC, Fudim M, Hall ME, Hernandez A, Morris AA, Shafi T, Weir MR & Zannad F (2023). Albuminuria and heart failure: JACC state-of-the-art review. Journal of the American College of Cardiology, 81(3), 270-82. DOI: 10.1038/s41598-022-81373-8.
16. Kolkhof P, Joseph A & Kintscher U (2021). Nonsteroidal mineralocorticoid receptor antagonism for cardiovascular and renal disorders− New perspectives for combination therapy. Pharmacological Research, 172, 105859. DOI: 10.1016/j.phrs.2021.105859.
17. Lanfranconi S, Scola E, Meessen JM, Pallini R, Bertani GA, Salman RA, Dejana E, Latini R, Fornara GA, Agnelli NM & Albanese A (2023). Safety and efficacy of propranolol for treatment of familial cerebral cavernous malformations (Treat_CCM): a randomised, open-label, blinded-endpoint, phase 2 pilot trial. The Lancet Neurology, 22(1), 35-44. DOI: 10.1016/S1474-4422(22)00409-4.
18. Liang J, Lan J, Tang Q, Ling W & Li M (2021). Short‑and long‑term treatment with angiotensin‑converting enzyme inhibitors or calcium channel blockers for the prevention of diabetic nephropathy progression: A meta‑analysis. Experimental and Therapeutic Medicine, 21(1), 1-. DOI: 10.3892/etm.2020.9446.
19. Loucks EB, Nardi WR, Gutman R, Kronish IM, Saadeh FB, Li Y, Wentz AE, Webb J, Vago DR, Harrison A & Britton WB (2019). Mindfulness-based BP reduction (MB-BP): stage 1 single-arm clinical trial. PloS one, 14(11), e0223095. DOI: 10.1371/journal.pone.0223095.
20. Lu AD, Gunzburger E, Glorioso TJ, Smith WB, Kenney RR, Whooley MA & Ho PM (2021). Impact of longitudinal virtual primary care on diabetes quality of care. Journal of General Internal Medicine, 1, 1-8. DOI: 10.1007/s11606-020-06547-x.
21. Luo C, Sanger N, Singhal N, Pattrick K, Shams I, Shahid H, Hoang P, Schmidt J, Lee J, Haber S, Puckering M (2020) A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. E Clinical Medicine, 24.DOI: https://doi.org/10.1016/j.eclinm.2020.100442.
22. Manolis AA, Manolis TA, Melita H & Manolis AS (2019). Eplerenone versus spironolactone in resistant hypertension: an efficacy and/or cost or just a men’s issue?. Current hypertension reports, 21, 1-4. DOI: 10.1007/s11906-019-0924-0.
23. Martin GL, Trioux T, Gaudry S, Tubach F, Hajage D & Dechartres A (2021). Association between lack of blinding and mortality results in critical care randomized controlled trials: a meta-epidemiological study. Critical care medicine, 49(10), 1800-11. DOI: 10.1097/CCM.0000000000005065.
24. Moroni G, Ponticelli C (2020) Secondary membranous nephropathy. A narrative review. Frontiers in Medicine, 7, 611317. DOI: 10.3389/fmed.2020.611317.
25. Muthamil P (2020). A Randomised Comparative study to Compare the Antiproteinuric Effects of Benedipine with Amlodipine in Mild to Moderate Stage Chronic Kidney Disease Patients (Doctoral dissertation, Coimbatore Medical College, Coimbatore). DOI: 10.1016/j.amjmed.2020.07049.
26. Ng KY, Cherian G, Kermack AJ, Bailey S, Macklon N, Sunkara SK & Cheong Y (2021). Systematic review and meta-analysis of female lifestyle factors and risk of recurrent pregnancy loss. Scientific reports, 11(1), 7081. DOI: 10.1038/s41598-021-86445-2.
27. Piperidou A, Sarafidis P, Boutou A, Thomopoulos C, Loutradis C, Alexandrou ME, Tsapas A & Karagiannis A (2019). The effect of SGLT-2 inhibitors on albuminuria and proteinuria in diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Journal of Hypertension, 37(7), 1334-43.DOI: 10.1097/HJH.0000000000002050.
28. Ram CV (2022). Therapeutic Usefulness of a Novel Calcium Channel Blocker Azelnidipine in the Treatment of Hypertension: A Narrative Review. Cardiology and Therapy, 11(4), 473-89. DOI: 10.1007/s40119-022-00276-4
29. Srinath S (2020). Comparison of Efficacy and Safety of Benidipine with Amlodipine in Patients with Uncomplicated Hypertension: A Prospective study (Doctoral dissertation, KarpagaVinayaga Institute of Medical Sciences and Research Centre, Kanchipuram). DOI: 10.1007/s40292-020-00459-2.
30. Syamala D (2023). COMPARATIVE OUTCOMES OF FIRST-LINE ANTIHYPERTENSIVE AGENTS ON RENAL FUNCTION IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE: AN OBSERVATIONAL COHORT STUDY. Int J Acad Med Pharm, 5(5), 497-501. DOI: 10.47009/jamp.2023.5.5.97.
31. Tenorio-Pedraza JM, Lippert J, Burghaus R & Scheerans C (2023). Meta-analysis of preclinical measures of efficacy in immune checkpoint blockade therapies and comparison to clinical efficacy estimates. Translational Medicine Communications, 8(1), 17. DOI: 10.1037/met0000470.
32. Uchida HA, Nakajima H, Hashimoto M, Nakamura A, Nunoue T, Murakami K, Hosoya T, Komoto K, Taguchi T, Akasaka T & Shiosakai K (2022). Efficacy and safety of esaxerenone in hypertensive patients with diabetic kidney disease: a multicenter, open-label, prospective study. Advances in Therapy, 9(11), 5158-75. DOI: 10.1007/12335-024-02284
33. Wilson WW, Chua RF, Wei P, Besser SA, Tung EL, Kolak M & Tabit CE (2022). Association between acute exposure to crime and individual systolic BP. American journal of preventive medicine, 62(1), 87-94. DOI: 10.1161/JAHA.122.025923
34. Zhang Y, He D, Zhang W, Xing Y, Guo Y, Wang F, Jia J, Yan T, Liu Y & Lin S (2020). ACE inhibitor benefit to kidney and cardiovascular outcomes for patients with non-dialysis chronic kidney disease stages 3–5: a network meta-analysis of randomised clinical trials. Drugs, 80, 797-811.
35. Zhao M, Zhang Z, Pan Z, Ma S, Chang M, Fan J, Xue S, Wang Y, Qu H & Zhang Y (2023). N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Pharmaceuticals, 16(3), 338. DOI: 10.3390/ph16030338.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Patel, D. J., Shah, U. N., Ganta, S. R., & Aneesh John, T. (2024). A systematic review of efficacy and safety for calcium channel blockers in the treatment of albuminuria in patients with diabetes and hypertension. Multidisciplinary Reviews, 6, 2023ss004. https://doi.org/10.31893/multirev.2023ss004

[1] Adachi H, Kakuma T, Kawaguchi M, Kumagai E & Fukumoto Y, KES Study Investigators (2019). Effects of eplerenone on BP and glucose metabolism in Japanese hypertensives with overweight or obesity. Medicine, 98(15), e14994. DOI: 10.1097/MD.0000000000014994.

[2] Arnold JT, Lloyd AB, Bailey SJ, Fujimoto T, Matsutake R, Takayanagi M, Nishiyama T & Fujii N (2020). The nitric oxide dependence of cutaneous microvascular function to independent and combined hypoxic cold exposure. Journal of Applied Physiology, 129(4), 947-56. DOI: 10.1152/japplphysiol.00487.2020.

[3] Arvanitis M, Qi G, Bhatt DL, Post WS, Chatterjee N, Battle A & McEvoy JW (2021). Linear and nonlinear Mendelian randomization analyses of the association between diastolic BP and cardiovascular events: the J-curve revisited. Circulation, 143(9), 895-906. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.049819.

[4] Brady TM, Charleston J, Ishigami J, Miller III ER, Matsushita K & Appel LJ (2021). Effects of different rest period durations prior to BP measurement: the best rest trial. Hypertension, 78(5), 1511-9.DOI: 10.1161/HYPERTENSIONAHA.121.17496.

[5] Brandt-Jacobsen NH, Johansen ML, Rasmussen J, Forman JL, Holm MR, Faber J, Rossignol P, Schou M & Kistorp C (2021). Effect of high-dose mineralocorticoid receptor antagonist eplerenone on urinary albumin excretion in patients with type 2 diabetes and high cardiovascular risk: data from the MIRAD trial. Diabetes & metabolism, 47(4), 101190. DOI: 10.1016/j.diabet.2020.08.005.

[6] Cativo EH, Lopez PD, Cativo DP, Atlas SA & Rosendorff C (2021). The effect of calcium channel blockers on moderate or severe albuminuria in diabetic, hypertensive patients. The American Journal of Medicine, 134(1), 104-13. DOI: 10.1016/j.amjmed.2020.05.039.

[7] Chung EY, Ruospo M, Natale P, Bolignano D, Navaneethan SD, Palmer SC & Strippoli GF (2020). Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD007004.pub4.

[8] Coresh J, Heerspink HJ, Sang Y, Matsushita K, Arnlov J, Astor BC, Black C, Brunskill NJ, Carrero JJ, Feldman HI & Fox CS (2019). Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies. The lancet Diabetes & endocrinology, 7(2), 115-27. DOI: https://doi.org/10.1016/S2213-8587(18)30313-9.

[9] Fici F, Ari Bakir E, IlkayYüce E, Kanuncu S, Makel W, Tarim BA & Robles NR (2020). PAIT-Survey Follow-Up: Changes in Albuminuria in Hypertensive Diabetic Patients with Mild-Moderate Chronic Kidney Disease. High BP & Cardiovascular Prevention, 27, 43-9. DOI: 10.1007/s40292-020-00358-1.

[10] Fu EL, Clase CM, Evans M, Lindholm B, Rotmans JI, Dekker FW, van Diepen M & Carrero JJ (2021). Comparative effectiveness of RASinhibitors and calcium channel blockers in individuals with advanced CKD: a nationwide observational cohort study. American Journal of Kidney Diseases, 77(5), 719-29. DOI: 10.1053/j.ajkd.2020.10.006.

[11] Fulton EA, McBrearty AR, Shaw DJ & Ridyard AE (2023). Response and survival of dogs with proteinuria (UPC> 2.0) treated with angiotensin converting enzyme inhibitors. Journal of Veterinary Internal Medicine. DOI:10.1111/jvim.16864.

[12] Gallo G, Volpe M & Rubattu S (2022). Angiotensin receptor blockers in the management of hypertension: a real-world perspective and current recommendations. Vascular Health and Risk Management, 507-15. DOI: https://doi.org/10.2147/VHRM.S337640.

[13] Jeong HS, Lim HS, Park HJ, Lee WS, Choi JO, Lee HS, Jo SH & Hong SJ (2021). Clinical outcomes between calcium channel blockers and angiotensin receptor blockers in hypertensive patients without established cardiovascular diseases during a 3-year follow-up. Scientific Reports, 11(1), 1783. DOI: 10.1038/s41598-021-81373-7.

[14] Kawanami D, Takashi Y, Muta Y, Oda N, Nagata D, Takahashi H & Tanabe M (2021). Mineralocorticoid receptor antagonists in diabetic kidney disease. Frontiers in Pharmacology, 12, 754239. DOI: 10.3389/fphar.2021.754239.

[15] Khan MS, Shahid I, Anker SD, Fonarow GC, Fudim M, Hall ME, Hernandez A, Morris AA, Shafi T, Weir MR & Zannad F (2023). Albuminuria and heart failure: JACC state-of-the-art review. Journal of the American College of Cardiology, 81(3), 270-82. DOI: 10.1038/s41598-022-81373-8.

[16] Kolkhof P, Joseph A & Kintscher U (2021). Nonsteroidal mineralocorticoid receptor antagonism for cardiovascular and renal disorders− New perspectives for combination therapy. Pharmacological Research, 172, 105859. DOI: 10.1016/j.phrs.2021.105859.

[17] Lanfranconi S, Scola E, Meessen JM, Pallini R, Bertani GA, Salman RA, Dejana E, Latini R, Fornara GA, Agnelli NM & Albanese A (2023). Safety and efficacy of propranolol for treatment of familial cerebral cavernous malformations (Treat_CCM): a randomised, open-label, blinded-endpoint, phase 2 pilot trial. The Lancet Neurology, 22(1), 35-44. DOI: 10.1016/S1474-4422(22)00409-4.

[18] Liang J, Lan J, Tang Q, Ling W & Li M (2021). Short‑and long‑term treatment with angiotensin‑converting enzyme inhibitors or calcium channel blockers for the prevention of diabetic nephropathy progression: A meta‑analysis. Experimental and Therapeutic Medicine, 21(1), 1-. DOI: 10.3892/etm.2020.9446.

[19] Loucks EB, Nardi WR, Gutman R, Kronish IM, Saadeh FB, Li Y, Wentz AE, Webb J, Vago DR, Harrison A & Britton WB (2019). Mindfulness-based BP reduction (MB-BP): stage 1 single-arm clinical trial. PloS one, 14(11), e0223095. DOI: 10.1371/journal.pone.0223095.

[20] Lu AD, Gunzburger E, Glorioso TJ, Smith WB, Kenney RR, Whooley MA & Ho PM (2021). Impact of longitudinal virtual primary care on diabetes quality of care. Journal of General Internal Medicine, 1, 1-8. DOI: 10.1007/s11606-020-06547-x.

[21] Luo C, Sanger N, Singhal N, Pattrick K, Shams I, Shahid H, Hoang P, Schmidt J, Lee J, Haber S, Puckering M (2020) A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. E Clinical Medicine, 24.DOI: https://doi.org/10.1016/j.eclinm.2020.100442.

[22] Manolis AA, Manolis TA, Melita H & Manolis AS (2019). Eplerenone versus spironolactone in resistant hypertension: an efficacy and/or cost or just a men’s issue?. Current hypertension reports, 21, 1-4. DOI: 10.1007/s11906-019-0924-0.

[23] Martin GL, Trioux T, Gaudry S, Tubach F, Hajage D & Dechartres A (2021). Association between lack of blinding and mortality results in critical care randomized controlled trials: a meta-epidemiological study. Critical care medicine, 49(10), 1800-11. DOI: 10.1097/CCM.0000000000005065.

[24] Moroni G, Ponticelli C (2020) Secondary membranous nephropathy. A narrative review. Frontiers in Medicine, 7, 611317. DOI: 10.3389/fmed.2020.611317.

[25] Muthamil P (2020). A Randomised Comparative study to Compare the Antiproteinuric Effects of Benedipine with Amlodipine in Mild to Moderate Stage Chronic Kidney Disease Patients (Doctoral dissertation, Coimbatore Medical College, Coimbatore). DOI: 10.1016/j.amjmed.2020.07049.

[26] Ng KY, Cherian G, Kermack AJ, Bailey S, Macklon N, Sunkara SK & Cheong Y (2021). Systematic review and meta-analysis of female lifestyle factors and risk of recurrent pregnancy loss. Scientific reports, 11(1), 7081. DOI: 10.1038/s41598-021-86445-2.

[27] Piperidou A, Sarafidis P, Boutou A, Thomopoulos C, Loutradis C, Alexandrou ME, Tsapas A & Karagiannis A (2019). The effect of SGLT-2 inhibitors on albuminuria and proteinuria in diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Journal of Hypertension, 37(7), 1334-43.DOI: 10.1097/HJH.0000000000002050.

[28] Ram CV (2022). Therapeutic Usefulness of a Novel Calcium Channel Blocker Azelnidipine in the Treatment of Hypertension: A Narrative Review. Cardiology and Therapy, 11(4), 473-89. DOI: 10.1007/s40119-022-00276-4

[29] Srinath S (2020). Comparison of Efficacy and Safety of Benidipine with Amlodipine in Patients with Uncomplicated Hypertension: A Prospective study (Doctoral dissertation, KarpagaVinayaga Institute of Medical Sciences and Research Centre, Kanchipuram). DOI: 10.1007/s40292-020-00459-2.

[30] Syamala D (2023). COMPARATIVE OUTCOMES OF FIRST-LINE ANTIHYPERTENSIVE AGENTS ON RENAL FUNCTION IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE: AN OBSERVATIONAL COHORT STUDY. Int J Acad Med Pharm, 5(5), 497-501. DOI: 10.47009/jamp.2023.5.5.97.

[31] Tenorio-Pedraza JM, Lippert J, Burghaus R & Scheerans C (2023). Meta-analysis of preclinical measures of efficacy in immune checkpoint blockade therapies and comparison to clinical efficacy estimates. Translational Medicine Communications, 8(1), 17. DOI: 10.1037/met0000470.

[32] Uchida HA, Nakajima H, Hashimoto M, Nakamura A, Nunoue T, Murakami K, Hosoya T, Komoto K, Taguchi T, Akasaka T & Shiosakai K (2022). Efficacy and safety of esaxerenone in hypertensive patients with diabetic kidney disease: a multicenter, open-label, prospective study. Advances in Therapy, 9(11), 5158-75. DOI: 10.1007/12335-024-02284

[33] Wilson WW, Chua RF, Wei P, Besser SA, Tung EL, Kolak M & Tabit CE (2022). Association between acute exposure to crime and individual systolic BP. American journal of preventive medicine, 62(1), 87-94. DOI: 10.1161/JAHA.122.025923

[34] Zhang Y, He D, Zhang W, Xing Y, Guo Y, Wang F, Jia J, Yan T, Liu Y & Lin S (2020). ACE inhibitor benefit to kidney and cardiovascular outcomes for patients with non-dialysis chronic kidney disease stages 3–5: a network meta-analysis of randomised clinical trials. Drugs, 80, 797-811.

[35] Zhao M, Zhang Z, Pan Z, Ma S, Chang M, Fan J, Xue S, Wang Y, Qu H & Zhang Y (2023). N-/T-Type vs. L-Type Calcium Channel Blocker in Treating Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Pharmaceuticals, 16(3), 338. DOI: 10.3390/ph16030338.

Abstract

References

How to cite