Fu E.L. et al studied renin-angiotensin system (RAS) inhibitor therapy in patients with advanced chronic kidney disease (CKD) as an alternative to calcium channel blockers (CCBs). They assessed the risks for kidney replacement therapy (KRT), mortality, and major adverse cardiovascular events (MACE) in patients with advanced CKD comparing RAS inhibitor to CCB therapy.

They observed-

• Significantly lower risk for KRT after new use of RAS inhibitors compared with new use of CCBs
• Similar risks for mortality and MACE after new use of RAS inhibitors compared with new use of CCBs . 

Thus they concluded that initiation of RAS inhibitor therapy confers kidney benefits among patients with advanced CKD, with similar cardiovascular protection as CCBs.

Source-Fu EL, Clase CM, Evans M  et al. Comparative Effectiveness of Renin-Angiotensin System Inhibitors and Calcium Channel Blockers in Individuals With Advanced CKD: A Nationwide Observational Cohort Study, American Journal of Kidney Diseases,2021;77(5):719-729. https://doi.org/10.1053/j.ajkd.2020.10.006.