ISBN: Table 62: Angiotensin receptor antagonist (ARB) versus placebo (CKD class 3b-4) Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with ARB (95% CI) All-cause mortality 2917 VERY LOWa,c due to risk of bias, imprecision (from 32 fewer to 40 more) Combined outcome: cardiovascular mortality or HF admission VERY LOWa,b,c due to risk of bias, indirectness, imprecision (from 86 fewer to 25 more) Morbid event (includes hospitalisation and death) VERY LOWa,b,c due to risk of bias, indirectness, imprecision (from 82 fewer to 0 more) Renal function: change in eGFR 2179 VERY LOWa,c due to risk of bias, imprecision The mean change in eGFR in the control groups was The mean in eGFR in the intervention groups was Renal failure - progression to dialysis 2911 VERY LOWa,c due to risk of bias, imprecision Not estimabled Not estimabled Not estimabled LOWa due to risk of bias (from 29 more to 104 more) a Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias b Downgraded by 1 increment due to indirectness, as compound outcome rather than numbers of admissions c Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with ARB (95% CI) d Unable to calculate as there were zero events in both arms Table 63: ARB high dose versus low dose (CKD class 3a/b) Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with low dose Risk difference with ARB high dose (95% CI) Combined outcome: death or HF hospitalisation 945 VERY LOWa,b due to risk of bias, indirectness (from 53 fewer to 36 more) a Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias b Downgraded 1 increment due to indirectness as outcome was compound rather than numbers of admissions Table 64: Beta-blocker versus placebo (CKD stages 3-4) Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with Beta-blocker (95% CI) All-cause mortality - CKD class 3a 1645 LOWb due to risk of bias Estimatea (from 5 fewer to 30 fewer) All-cause mortality - CKD class 3b-4 958 HR 0.55 Estimatea Treating Heart Failure Chronic Heart Failure NICE 2018. 