Overall, sixteen RCTs were included (2031 participants).
Microalbuminuria at baseline (9 RCTs, 642 patients).
Post therapy, the average MAP was less in ACE inhibitor treated patients across all studies but one.
ACE inhibitors significantly reduced the risk of macroalbuminuria. RR = 0.35 (95% CI: 0.24, 0.53). There was no evidence of heterogeneity (Q = 2.26; P = 0.95).
Sensitivity analysis showed no difference in effect whether calculated using a fixed-effect or random-effects model.
There was one reported death due to accident in each treatment group.
Overt proteinuria at baseline (7 RCTs, 1389 patients).
ACE inhibitors significantly reduced the risk of macroalbuminuria. RR = 0.60 (95% CI: 0.49, 0.73). There was no evidence of heterogeneity (Q = 5.4; P = 0.50).
Sensitivity analysis showed no difference in effect whether calculated using a fixed-effect or random-effects model.
Exclusion of the one unpublished study did not markedly change the relative risk. RR = 0.57 (95% CI: 0.46, 0.73).
Death: there was no significant difference in the mortality rate between treatment groups. RR = 1.05 (95% CI: 0.57, 1.95).