title: Enalapril versus losartan for adults with chronic kidney disease: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Both enalapril and losartan are effective and widely used in patients with chronic kidney disease (CKD). This review aimed to evaluate the benefits of enalapril and losartan in adults with CKD.
  
  
  METHODS
  PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched, without language limitations, for randomized controlled trials (RCT), in which enalapril and losartan were compared in adults with CKD. Standard methods, consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, were used. Reviewer Manager software, ver. 5.2, was used for meta-analysis.
  
  
  RESULTS
  Of 318 citations retrieved, 17 RCT (14 parallel-group and three cross-over) met our inclusion criteria. The pooled analysis for parallel RCT showed that the effects of enalapril and losartan on blood pressure, renal function and serum uric acid (UA) were similar. Meta-analysis indicated that patients taking enalapril had a higher risk of dry cough (risk ratio, 2.88; 95% CI, 1.11-7.48; P=0.03). Sensitivity analysis showed good robustness of these findings.
  
  
  CONCLUSIONS
  Enalapril has similar effects to losartan on systemic blood pressure, renal function and serum UA in patients with CKD, but carries a higher risk of dry cough. Larger trials are required to evaluate the effects of these medications on clinical outcomes.
authors.affiliation: Renal Division, Department of Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Yuan-Mei
authors.initials: YM
authors.lastname: He
authors.forename: Li
authors.initials: L
authors.lastname: Feng
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Huo
authors.forename: Zhen-Hua
authors.initials: ZH
authors.lastname: Yang
authors.forename: Yun-Hua
authors.initials: YH
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D003371:Cough / Q000139:chemically induced; D003404:Creatinine / Q000097:blood; D004656:Enalapril / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D019808:Losartan / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012307:Risk Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D014527:Uric Acid; D004656:Enalapril; D003404:Creatinine; D019808:Losartan
keywords: adults; chronic kidney disease; enalapril; losartan