Abstract:
Carvedilol is supposed to have nephroprotective effects owing to
its additional antioxidant activity. We aimed to analyse the nephroprotective
efficacy of carvedilol versus other active treatments and placebo using its effect
on urine albumin to creatinine ratio (UACR).
Methods: Electronic database search in PUBMED, EMBASE, cochrane library
was conducted using search terms “carvedilol” and “proteinuria”. Randomized
or cross-over studies comparing effects of carvedilol versus other active
treatment or placebo were included under analysis. Inverse variance method and
both random and fixed effect models were used in the analysis. RevMan 5.3
software was used for statistical analysis.
Results: Total four studies (n) were eligible with 1036 (N) patients included in
the analysis. Carvedilol failed to show significant effect on UACR when
compared with all active treatments (standardised mean difference, SMD = -
0.80 mg/g, 95% CI = -2.37, 0.76, n=5, N=1036) and placebo (mean difference,
MD = -0.88 mg/g, 95% CI=-5.26, 3.51, n=2, N=75). It was superior to beta-1
blockers (SMD = -0.26 mg/g, 95% CI=-0.39, -0.13, n=2, N=963) and inferior to
ACEIs/ARBs (MD = 7.45, 95% CI=0.29, 14.61, n=2, N=73).
Conclusions: There are low quality evidences to suggesting nephroprotective
efficacy of carvedilol to be superior to beta-1 blockers in patients especially
with diabetes as co-morbidity. Considering the drawbacks of our study, results
need to be cautiously interpreted.
