Evidence Table 15Evidence profile of chronic kidney disease trials: Valsartan compared with ramipril

Quality AssessmentSummary of Findings
Results by study, Relative effectQuality of the evidence for each outcome
StudyDesignQualityInconsistencyIndirectnessImprecisionOther considerations
Changes in renal function- serum creatinine
Esnault 2005
n = 18
Randomized cross- over trialFairn/aDirectImpreciseNSD between groupsVery Low
Changes in renal function-estimated GFR
Yilmaz 2007
n = 66
Controlled head to head trialFairn/aDirectImpreciseNSD between groupsVery Low
Changes in renal function-proteinuria
Esnault 2005
n = 18
Randomized cross- over trialFairInconsistentDirectImpreciseIn the trial where ACEI was superior, blood pressures were also lower in those on ACEINSD between groupsLow
Yilmaz 2007
n = 66
Controlled head to head trialFairProteinuria was lowered more with ACEI than AIIRA (p = 0.02), but blood pressure control was not equivalent.
Specific harm-hypotension
Esnault 2005
n = 18
Randomized cross-over studyFairn/aDirectImpreciseSpecifically notes only that no hypotension events occurred in either group.NSD between groupsVery Low

Withdrawals were not delineated by treatment groups. One trial reported adverse events each group, but then did not specify which adverse events for which group.

From: Evidence Tables

Cover of Drug Class Review: Direct Renin Inhibitors, Angiotensin Converting Enzyme Inhibitors, and Angiotensin II Receptor Blockers
Drug Class Review: Direct Renin Inhibitors, Angiotensin Converting Enzyme Inhibitors, and Angiotensin II Receptor Blockers: Final Report [Internet].
Norris S, Weinstein J, Peterson K, et al.
Portland (OR): Oregon Health & Science University; 2010 Jan.
Copyright © 2009, Oregon Health & Science University, Portland, Oregon.

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