Types of participants: Inclusion criteria: Randomized controlled trials, examining effect of Renin-angiotensin system blockade on the renal and cardiovascular events in patients with chronic kidney disease for more than six months. Exclusion criteria: 1) non- RCTs 2) Trials did not meet the criteria of CKD (Chronic kidney disease was defined as CKD as per the KDOQI guidelines) 3) Trials without the intervening of ACEI and/or ARB or Aliskiren. 4) Trials without renal events or cardiovascular events or other adverse events. Type of intervention: Use the Rennin-angiotensin system blockade agent ACE-Is or/and ARBs or rennin-inhibiter agent Aliskiren. Type of outcome measures: 1) End-stage kidney disease 2) Doubling of serum creatinine level 3) 50% or more decline in GFR 4) Kidney failure (defined as a composite of any of the following; doubling of serum creatinine level, 50% decline in GFR, or end-stage kidney disease) 5) Fatal/non fatal heart failure 6) Fatal/non fatal stroke 7) Fatal/non fatal myocardial infarction 8) Major cardiovascular event including fatal/non fatal myocardial infarction, heart failure, stroke 9) Cardiovascular mortality 10) All-cause Mortality 11) Any adverse events, including adverse event related to hyperkalemia cough angioedema oedema hypotension serious adverse events. 12) Proteinuria 13) Serum creatinine 14) GFR 15) SBP and DBP 16) Other cardiovascular disorder The search strategy MEDLINE (OVID) 1. exp Angiotensin-Converting Enzyme Inhibitors/ 2. angiotensin converting enzyme inhibit$.tw. 3. (ace adj2 inhibit$).tw. 4. (ACE or ACE1 or ACEI or ACE-I or ACEs). 5.alacepril.tw. 6.benazepril.tw. 7.benazeprila.tw. 8. captopril.tw. 9. enalapril.tw.
10. cilazapril.tw. 11. enalaprilat.tw. 12. fosinopril.tw. 13. lisinopril.tw. 14. perindopril.tw. 15. ramipril.tw. 16. benazeprilat.tw. 17. ceranapril.tw. 18. cilazaprilat.tw. 19. delapril.tw. 20.fosinoprilic acid.tw. 21. imidapril.tw. 22. libenzapril.tw. 23. quinaprilat.tw. 24. ramiprilat.tw. 25. rentiapril.tw. 26. saralasin.tw. 27. spirapril.tw. 28.temocapril hydrochloride 29. teprotide.tw. 30. zofenopril.tw. 31. trandolapril.tw. 32.quinapril.tw. 33.moexipril.tw. 34.ceronapril.tw. 35. deacetylalacepril.tw. 36.fosinopril$. 37.losartan.tw. 38.azilsartan.tw. 39.elisartan.tw 40.embusartan.tw. 41.forasartan.tw. 42.saprisartan.tw. 43.tasosartan.tw. 44.vasvalsartan.tw. 45.zolasartan.tw. 46.miardis.tw. 47.cozaar.tw. 48.atacand.tw. 49.teveten.tw. 50.avapro.tw. 51.micardis.tw. 52.avalide.tw. 53.aprovel.tw.
54.amias.tw. 55.diovan.tw. 56.olmetec.tw. 57. irbesartan.tw. 58. candesartan.tw. 59. eprosartan.tw. 60. valsartan.tw. 61. olmesartan.tw. 62. telmisartan.tw. 63. (ace adj2 inhibitor$).tw. 64. (angiotensin adj2 receptor antagonist$).tw. 65.ARB.tw. 66.Angiotensin 2 Receptor Antagonist.tw. 67.Angiotensin Receptor Antagonist.tw. 68.Angiotensin II Antagonist.tw. 69.AT 2 receptor blocker.tw. 70.AT 2 receptor antagonist.tw. 71. aliskiren.tw. 72. or/1-71 73. (kidney disease or renal disease).tw. 74. Kidney Failure, Chronic/ 75. Kidney Failure/ 76. (chronic kidney or chronic renal).tw. 77. Renal Insufficiency, Chronic/ or Kidney Failure, Chronic/ 78. Uremia/ 79. (CKD or CKF or CRF or ESRD or ESKF or ESRF or ESKD or CRD).tw. 80. (end-stage renal or end-stage kidney or endstage renal or endstage kidney).tw. 81. renal replacement therapy/ or exp renal dialysis/ or exp hemofiltration/ 82. (predialysis or dialysis).tw. 83. (haemodialysis or haemodialysis).tw. 84. (hemofiltration or haemofiltration).tw. 85. (hemodiafiltration or haemodiafiltration).tw. 86. (CAPD or CCPD or APD or PD).tw. 87. exp Proteinuria/ 88. proteinuria.tw. 89.albuminuria.tw. 90.macroalbuminuria.tw. 91.microalbuminuria.tw. 92.(urin$ adj6 (protein$ or albumin$ or microalbumin$)).tw. 93. or/73-92 94. Randomized controlled trial.pt. 95.Controlled clinical trial.pt 96. Randomized.tw. 97. Placebo.tw.
98.Drug therapy/ 99.Randomly.tw. 100.Trial.tw. 101.Groups.tw. 102.(random$ adj5 trial$).tw. 103. (random$ adj5 allocation$).tw. 104.(Blind$ adj5 method$).tw. 105.or/94-104 106. 72 and 93 and 105 EMBASE 1. exp Angiotensin-Converting Enzyme Inhibitors 2. angiotensin adj2 receptor antagonist$ 3. Angiotensin 2 Receptor Antagonist 4. Angiotensin Receptor Antagonist 5. Angiotensin II Antagonist 6. AT 2 receptor blocker 7. AT 2 receptor antagonist 8. fosinopril$ 9.losartan 10.azilsartan 11.elisartan 12.embusartan 13.forasartan 14.saprisartan 15.tasosartan 16.vasvalsartan 17.zolasartan 18.miardis 19.cozaar 20.atacand 21.teveten 22.avapro 23.micardis 24.avalide 25.aprovel 26.amias 27.diovan 28.olmetec 29. irbesartan 30. candesartan 31. eprosartan 32. valsartan 33. olmesartan
34. telmisartan 35. ace adj2 inhibitor$ 36. angiotensin converting enzyme inhibit$ 37. ace adj2 inhibit$ 38. ACE or ACE1 or ACEI or ACE-I or ACE 39.alacepril 40.benazepril 41.benazeprila 42. captopril 43. enalapril 44. cilazapril 45. enalaprilat 46. fosinopril 47. lisinopril 48. perindopril 49. ramipril 50. benazeprilat 51. ceranapril 52. cilazaprilat 53. delapril 54. fosinoprilic acid 55. imidapril 56. libenzapril 57. quinaprilat 58. ramiprilat 59. rentiapril 60. saralasin 61. spirapril 62.temocapril hydrochloride 63. teprotide 64. zofenopril 65. trandolapril 66.quinapril 67.moexipril 68.ceronapril 69. deacetylalacepril 70. aliskiren 71.or/1-70 72. kidney disease or renal disease 73. Kidney Failure, Chronic 74. Kidney Failure 75. chronic kidney or chronic renal 76. Uremia 77. CKD or CKF or CRF or ESRD or ESKF or ESRF or ESKD or CRD
78. end-stage renal or end-stage kidney or endstage renal or endstage kidney 79. predialysis or dialysis 80. haemodialysis or haemodialysis 81. hemodiafiltration or haemodiafiltration 82. CAPD or CCPD or APD or PD 83. exp Proteinuria 84. proteinuria 85. macroalbuminuria 86. microalbuminuria 87. albuminuria 88. or/72-87 89. Randomized controlled trial 90. Controlled clinical trial 91. blind and method 92. randomized and controlled and trial 93. random and allocation 94. or/89-93 95. 71 and 88 and 94 COCHRANE CONTROLLED TRIALS 1. (kidney disease or renal disease).tw. 2. Kidney Failure, Chronic/ 3. Kidney Failure/ 4. (chronic kidney or chronic renal).tw. 5. Renal Insufficiency, Chronic/ or Kidney Failure, Chronic/ 6. Uremia/ 7. (CKD or CKF or CRF or ESRD or ESKF or ESRF or ESKD or CRD).tw. 8. (end-stage renal or end-stage kidney or endstage renal or endstage kidney).tw. 9. renal replacement therapy/ or exp renal dialysis/ or exp hemofiltration/ 10. (predialysis or dialysis).tw. 11. (haemodialysis or haemodialysis).tw. 12. (hemofiltration or haemofiltration).tw. 13. (hemodiafiltration or haemodiafiltration).tw. 14. (CAPD or CCPD or APD or PD).tw. 15. exp Proteinuria/ 16. proteinuria.tw. 17. albuminuria.tw. 18. macroalbuminuria.tw. 19. microalbuminuria.tw. 20. (urin$ adj6 (protein$ or albumin$ or microalbumin$)).tw. 21. or/1-20 22. exp Angiotensin-Converting Enzyme Inhibitors/ 23. angiotensin converting enzyme inhibit$.tw. 24. (ace adj2 inhibit$).tw.
25. (ACE or ACE1 or ACEI or ACE-I or ACEs).tw. 26. alacepril.tw. 27. benazepril.tw. 28. benazeprila.tw. 29. captopril.tw. 30. enalapril.tw. 31. cilazapril.tw. 32. enalaprilat.tw. 33. fosinopril.tw. 34. lisinopril.tw. 35. perindopril.tw. 36. ramipril.tw. 37. benazeprilat.tw. 38. ceranapril.tw. 39. cilazaprilat.tw. 40. delapril.tw. 41.fosinoprilic acid.tw. 42. imidapril.tw. 43. libenzapril.tw. 44. quinaprilat.tw. 45. ramiprilat.tw. 46. rentiapril.tw. 47. saralasin.tw. 48. spirapril.tw. 49.temocapril hydrochloride 50. teprotide.tw. 51. zofenopril.tw. 52. trandolapril.tw 53. quinapril.tw. 54. moexipril.tw. 55. ceronapril 56. deacetylalacepril.tw. 57. fosinopril$. 58. losartan.tw. 59. azilsartan.tw. 60. elisartan.tw 61. embusartan.tw. 62. forasartan.tw. 63. saprisartan.tw. 64. tasosartan.tw. 65. vasvalsartan.tw. 66. zolasartan.tw. 67. miardis.tw. 68. cozaar.tw.
69. atacand.tw. 70. teveten.tw. 71. avapro.tw. 72. micardis.tw. 73. avalide.tw. 74. aprovel.tw. 75. amias.tw. 76. diovan.tw. 77. olmetec.tw. 78. irbesartan.tw. 79. candesartan.tw. 80. eprosartan.tw. 81. valsartan.tw. 82. olmesartan.tw. 83. telmisartan.tw. 84. (ace adj2 inhibitor$).tw. 85. (angiotensin adj2 receptor antagonist$).tw. 86. ARB.tw. 87. Angiotensin 2 Receptor Antagonist.tw. 88. Angiotensin Receptor Antagonist.tw. 89. Angiotensin II Antagonist.tw. 90. AT 2 receptor blocker.tw. 91.AT 2 receptor antagonist.tw. 92. aliskiren.tw. 93. or/22-92 94. Randomized controlled trial.pt. 95. Controlled clinical trial.pt 96. Randomized.tw. 97. Placebo.tw. 98. Drug therapy/ 99. Randomly.tw. 100.Trial.tw. 101. Groups.tw. 102. (random$ adj5 trial$).tw. 103. (random$ adj5 allocation$).tw. 104. (Blind$ adj5 method$).tw. 105. or/94-104 106. 21 and 93 and 105