Evidence map›Paper›PMID 15459003›Full record

SynthesisBMJ (Clinical research ed.)2004

Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review.

Giovanni F M Strippoli, Maria Craig, Jonathan J Deeks, Francesco Paolo Schena, Jonathan C Craig

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 15 pooled it
26.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 15 syntheses or guidelines pooled it, 385 citations in OpenAlex.

  1. Pooled it
  2. A European Renal Association (ERA) synopsis for nephrology practice of the 2023 European Society of Hypertension (ESH) Guidelines for the Management of Arterial Hypertension.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
    Guideline
  3. Pooled it
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  6. An evidence-based systematic review of the off-label uses of lisinopril.British journal of clinical pharmacology · 2018
    Pooled it
  7. Guideline
  8. Pooled it
  9. Pooled it
  10. Antihypertensive agents for preventing diabetic kidney disease.The Cochrane database of systematic reviews · 2012
    Pooled it
  11. Pooled it
  12. Heparin and related substances for preventing diabetic kidney disease.The Cochrane database of systematic reviews · 2010
    Pooled it
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  15. Pooled it
  16. Trial
  17. Trial
  18. A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease.Clinical journal of the American Society of Nephrology : CJASN · 2012
    Trial
  19. Article
  20. 2024 Thai guidelines on the treatment of hypertension.Asian biomedicine : research, reviews and news · 2025
    Article

32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Giovanni F M StrippoliNHMRC Centre for Clinical Research Excellence in Renal Medicine, Cochrane Renal Group, Children's Hospital at Westmead, Westmead, NSW 2145, Australia. gfmstrippoli@katamail.com
Maria Craig
Jonathan J Deeks
Francesco Paolo Schena
Jonathan C Craig
Children's Hospital at Westmead · AUUniversity of Bari Aldo Moro · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effects of angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (AIIRAs) on renal outcomes and all cause mortality in patients with diabetic nephropathy. DATA SOURCES: Medline, Embase, the Cochrane controlled trials register, conference proceedings, and contact with investigators. STUDY SELECTION: Trials comparing ACE inhibitors or AIIRAs with placebo or with each other in patients with diabetic nephropathy. DATA EXTRACTION: Mortality, renal outcomes (end stage renal disease, doubling of serum creatinine concentration, prevention of progression of microalbuminuria to macroalbuminuria, remission of microalbuminuria), and quality of trials. DATA SYNTHESIS: 36 of 43 identified trials compared ACE inhibitors with placebo (4008 patients), four compared AIIRAs with placebo (3331 patients), and three compared ACE inhibitors with AIIRAs (206 patients). We obtained unpublished data for 11 trials. ACE inhibitors significantly reduced all cause mortality (relative risk 0.79, 95% confidence interval 0.63 to 0.99) compared with placebo but AIIRAs did not (0.99, 0.85 to 1.17), although baseline mortality was similar in the trials. Both agents had similar effects on renal outcomes. Reliable estimates of the unconfounded relative effects of ACE inhibitors compared with AIIRAs could not be obtained owing to small sample sizes.

conclusionAlthough the survival benefits of ACE inhibitors for patients with diabetic nephropathy are known, the relative effects of ACE inhibitors and AIIRAs on survival are unknown owing to the lack of adequate head to head trials.

Indexed as

Angiotensin-Converting Enzyme InhibitorsAngiotensin II Type 2 Receptor BlockersDiabetes Mellitus, Type 2Diabetic NephropathiesHumansRandomized Controlled Trials as TopicTreatment OutcomeAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 2 Receptor Blockers

Identifiers

PMID15459003
PMCPMC521570
OpenAlexW2097433411

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.