Abstract:

Objectives： We conducted a systematic review to study the safety and efficacy of ACEI and ARB use in PD patients. Methodology: PubMed, MEDLINE, Cochrane Library, CNKI, weipu database, CBM, Wanfang database and other databases were searched. The qualities of included articles were assessed and then a meta-analysis was conducted by using RevMan 5.1 software. Result：Meta-analysis results were as follows：（1）The ACEI/ARB group have a higher renal function, KT/V, more 24 hours urine, and CrCL compared with the control group. The WMD respectively are [ 0.47 95% CI90.32~0.62)], [197.66, 95% CI (140.78~254.54)]，[0.11, 95% CI (0.00~0.22)]；[4,95% CI (-2.46~10.46)]（2）The thickness of interventricular in ACEI/ARB group was thinner than the control group [WMD=-1.32，95%CI-2.17~-0.47，P=0.002]，While the ventricular end-diastolic volume was smaller than the control group [ WMD=-3.39, 95%CI（-4.26, -2.51）]; Left ventricular eject fraction was higher in ACEI/ARB group.（3）No significant difference between the two group in serum potassium level [WMD=0.04, 95% CI（-0.015~0.23）]. Conclusion: In PD patients, the ACEI/ARB effectively slowed the loss of residual renal function, maintained the hemodynamics in stable, protected cardiac function, and delayed myocardial remodeling; But evidences for the use of ACEIs/ ARBs for reduction of mortality and CV events was lacking.

Key words: Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, peritoneal dialysis, Meta-analysis