title: Angiotensin-converting enzyme inhibitors and type 2 diabetic nephropathy: a meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis on studies evaluating the effect of angiotensin-converting enzyme (ACE) inhibitors on diabetic nephropathy in patients with type 2 diabetes mellitus.
  
  
  METHODS
  A computerized literature search was conducted for articles of studies comparing ACE inhibitors with a control in patients with diabetes, in which measurement of albuminuria or proteinuria was an outcome. Each article was abstracted by two of the authors. Data from the articles were presented as geometric or arithmetic means. The data were summarized separately by using standard techniques for meta-analysis.
  
  
  RESULTS
  Statistically significant reductions in albuminuria were observed regardless of whether data were described with geometric or arithmetic means. Both were associated with significant heterogeneity. When studies reporting geometric means were stratified and analyzed, the heterogeneity was lost and statistically significant reductions in albuminuria were observed. The same procedure was repeated for studies reporting arithmetic means, but heterogeneity remained.
  
  
  CONCLUSIONS
  The ACE inhibitors produce statistically significant reductions in albuminuria associated with significant heterogeneity of effect. Stratification reduces the heterogeneity and supports treatment with ACE inhibitors to reduce the progression of nephropathy in patients with type 2 diabetes mellitus.
authors.affiliation: Department of Pharmacy Practice, Albany College of Pharmacy, Albany, New York 12208, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hamilton
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kane
authors.forename: Jason
authors.initials: J
authors.lastname: Demers
mesh_terms: D000419:Albuminuria / Q000188:drug therapy / Q000209:etiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D015201:Meta-Analysis as Topic; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D016032:Randomized Controlled Trials as Topic
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors