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

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.