To the Editor: We read with interest the letter from Dr Catalá-López [1] commenting on our paper [2]. We performed a network meta-analysis of the reno-protective effects of renin–angiotensin–aldosterone system blockers in type 2 diabetic patients [2]. We combined ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), similar to the previous meta-analysis that compared the combined effects only to placebo [3]. Most importantly, there was very little evidence of any heterogeneity to suggest that ACEIs and ARBs are substantially different. Furthermore, current guidelines for kidney protection in diabetic patients [4] recommend the prescription of either ACEIs or ARBs.

We acknowledge that, because of its sample size, the study by Lewis et al [5] was the greatest contributor to the pooled RR for end-stage renal disease in direct meta-analysis (89.7%). We also acknowledge differences in the design of trials included in the analysis; however, this is quite common when performing a meta-analysis. We did not include the olmesartan trial [6], because this was published after the end of our search (July 2011).