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Background:Renin-angiotensin system inhibitor and calcium channel blocker (CCB) are widely used in controlling blood pressure (BP) in patients with chronic kidney disease (CKD).We carried out a meta-analysis to compare the renoprotective effect of the combination of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) and CCB (i.e.,ACEI/ARB + CCB) with ACEI/ ARB monotherapy in patients with hypertension and CKD.Methods:Publications were identified from PubMed,Embase,Medline,and Cochrane databases.Only randomized controlled trials (RCTs) of BP lowering treatment for patients with hypertension and CKD were considered.The outcomes of end-stage renal disease (ESRD),cardiovascular events,BP,urinary protein measures,estimated glomerular filtration rate (GFR),and adverse events were extracted.Results:Based on seven RCTs with 628 patients,ACEI/ARB + CCB did not show additional benefit for the incidence of ESRD (risk ratio [RR] =0.84;95％ confidence interval [CI]:0.52-1.33) and cardiovascular events (RR =0.58;95％ CI:0.21-1.63) significantly,compared with ACEI/ARB monotherapy.There were no significant differences in change from baseline to the end points in diastolic BP (weighted mean difference [WMD] =-1.28 mmHg;95％ CI:-3.18 to-0.62),proteinuria (standard mean difference =-0.55;95％ CI:-1.41 to-0.30),GFR (WMD =-0.32 ml/min;95％ CI:-1.53 to-0.89),and occurrence of adverse events (RR =1.05;95％ CI:0.72-1.53).However,ACEI/ARB + CCB showed a greater reduction in systolic BP (WMD =-4.46 mmHg;95％ CI:-6.95 to-1.97),compared with ACEI/ARB monotherapy.Conclusion:ACEI/ARB + CCB had no additional renoprotective benefit beyond than what could be achieved with ACEI/ARB monotherapy.