Effect of Angiotensin-Converting Enzyme Inhibitors on Progression of Nondiabetic Renal Disease

Letters20 August 2002Effect of Angiotensin-Converting Enzyme Inhibitors on Progression of Nondiabetic Renal DiseaseTazeen H. Jafar, MD, MPH, Christopher H. Schmid, PhD, and Andrew S. Levey, MDTazeen H. Jafar, MD, MPHThe Aga Khan University; Karachi, PakistanTufts University School of Medicine; Boston, MA 02111, Christopher H. Schmid, PhDThe Aga Khan University; Karachi, PakistanTufts University School of Medicine; Boston, MA 02111, and Andrew S. Levey, MDThe Aga Khan University; Karachi, PakistanTufts University School of Medicine; Boston, MA 02111Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-4-200208200-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In our article on angiotensin-converting enzyme (ACE) inhibitors and progression of nondiabetic renal disease (1), we stated that regimens containing ACE inhibitors are more effective in slowing the progression of nondiabetic renal disease than regimens that do not include them. Drs. Schrier and Estacio, in their accompanying editorial (2), consider our findings "an exciting hypothesis that warrants confirmation" and state that meta-analysis cannot produce definitive conclusions. Others have concluded, however, that a well-conducted meta-analysis of randomized clinical trials of individual patient data provides the highest level of evidence in support of a therapeutic intervention (3).All of ...References1. Jafar TH, Schmid CH, Landa M, Giatras I, Toto R, Remuzzi G, et al . Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data. Ann Intern Med. 2001;135:73-87. [PMID: 11453706] LinkGoogle Scholar2. Schrier RW, Estacio RO. The effect of angiotensin-converting enzyme inhibitors on the progression of nondiabetic renal disease: a pooled analysis of individual-patient data from 11 randomized, controlled trials [Editorial]. Ann Intern Med. 2001;135:138-9. [PMID: 11453714] LinkGoogle Scholar3. Olkin I. Statistical and theoretical considerations in meta-analysis. J Clin Epidemiol. 1995; 48:133-46; discussion 147. [PMID: 7853039] Google Scholar Author, Article, and Disclosure InformationAuthors: Tazeen H. Jafar, MD, MPH; Christopher H. Schmid, PhD; Andrew S. Levey, MDAffiliations: The Aga Khan University; Karachi, PakistanTufts University School of Medicine; Boston, MA 02111 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAngiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease Tazeen H. Jafar , Christopher H. Schmid , Marcia Landa , Ioannis Giatras , Robert Toto , Giuseppe Remuzzi , Giuseppe Maschio , Barry M. Brenner , Annelise Kamper , Pietro Zucchelli , Gavin Becker , Andres Himmelmann , Kym Bannister , Paul Landais , Shahnaz Shahinfar , Paul E. de Jong , Dick de Zeeuw , Joseph Lau , Andrew S. Levey , and The Effect of Angiotensin-Converting Enzyme Inhibitors on the Progression of Nondiabetic Renal Disease: A Pooled Analysis of Individual-Patient Data from 11 Randomized, Controlled Trials Robert W. Schrier and Raymond O. 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