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Should We STOP Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers in Advanced Kidney Disease?

Published on Jan 1, 2016in Nephron2.085
· DOI :10.1159/000447068
Aimun Ahmed1
Estimated H-index: 1
,
Tom Jorna1
Estimated H-index: 1
,
Sunil Bhandari Frcp26
Estimated H-index: 26
Abstract
Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD) and impaired quality of life. Previous research for preventing loss
  • References (89)
  • Citations (10)
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References89
Newest
#1Sripal Bangalore (NYU: New York University)H-Index: 53
#2Robert J. Fakheri (NYU: New York University)H-Index: 7
Last. Franz H. Messerli (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 82
view all 4 authors...
Objective To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. Design Meta-analysis. Data sources and study selection PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, re...
55 CitationsSource
Background and objectives Patients with CKD are more likely than others to have abnormalities in serum potassium (K + ). Aside from severe hyperkalemia, the clinical significance of K + abnormalities is not known. We sought to examine the association of serum K + with mortality and hospitalization rates within narrow eGFR strata to understand how the burden of hyperkalemia varies by CKD severity. Associations were examined between serum K + and discontinuation of medications that block the renin...
75 CitationsSource
#1Chia-Jen Shih (NYMU: National Yang-Ming University)H-Index: 10
#2Hsi Chu (NYMU: National Yang-Ming University)H-Index: 6
Last. Yung-Tai Chen (NYMU: National Yang-Ming University)H-Index: 18
view all 4 authors...
article i nfo Background:Guidelinesforhypertensionmanagementrecommendeitherangiotensin-convertingenzymeinhib- itors (ACEIs) or angiotensin II receptor blockers (ARBs) as first-line therapies for diabetes population. No head- to-head trial has been conducted to determine the priority of ACEI/ARB use for major adverse cardiac events (MACEs) in diabetes mellitus. Methods: Data on patients with newly diagnosed diabetes treated with ACEIs or ARBs were collected from Taiwan's National Health Insurance...
6 CitationsSource
#1Sunil Bhandari Frcp (Hull York Medical School)H-Index: 26
#2Natalie Ives (University of Birmingham)H-Index: 26
Last. Meguid El NahasH-Index: 15
view all 9 authors...
Background Blood pressure (BP) control and reduction of urinary protein excretion using agents that block the renin–angiotensin aldosterone system are the mainstay of therapy for chronic kidney disease (CKD). Research has confirmed the benefits in mild CKD, but data on angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use in advanced CKD are lacking. In the STOP-ACEi trial, we aim to confirm preliminary findings which suggest that withdrawal of ACEi/ARB treatme...
32 CitationsSource
#1Hiddo J. Lambers Heerspink (UMCG: University Medical Center Groningen)H-Index: 45
#2Tobias F. Kröpelin (UMCG: University Medical Center Groningen)H-Index: 5
Last. Dick de Zeeuw (UMCG: University Medical Center Groningen)H-Index: 88
view all 4 authors...
Albuminuria has been proposed as a surrogate end point in randomized clinical trials of renal disease progression. Most evidence comes from observational analyses showing that treatment-induced short-term changes in albuminuria correlate with risk change for ESRD. However, such studies are prone to selection bias and residual confounding. To minimize this bias, we performed a meta-analysis of clinical trials to correlate the placebo-corrected drug effect on albuminuria and ESRD to more reliably ...
110 CitationsSource
#1Raghav T. BhatiaH-Index: 1
#2Oliver T BrowneH-Index: 2
Last. Sunil Bhandari FrcpH-Index: 26
view all 5 authors...
Background: With an aging population and limited resources, the incidence and prevalence of chronic kidney disease is increasing. We aimed at assessing the impact of the low clearance clinic (LCC) on not only the natural history of patients with deteriorating renal function but also the timing of renal replacement therapy (RRT) and mortality. Methods: A retrospective cohort study involving 271 patients who entered the LCC at Hull from July 2007 to December 2010 was conducted. Descriptive analysi...
1 CitationsSource
#1Marcel H.A. Muskiet (VU: VU University Amsterdam)H-Index: 9
#2Lennart Tonneijck (VU: VU University Amsterdam)H-Index: 15
Last. Daniël H. van Raalte (VU: VU University Amsterdam)H-Index: 21
view all 6 authors...
Summary In parallel with the type 2 diabetes pandemic, diabetic kidney disease has become the leading cause of end-stage renal disease worldwide, and is associated with high cardiovascular morbidity and mortality. As established in landmark randomised trials and recommended in clinical guidelines, prevention and treatment of diabetic kidney disease focuses on control of the two main renal risk factors, hyperglycaemia and systemic hypertension. Treatment of systemic hypertension with angiotensin-...
38 CitationsSource
#1Jun Cheng (ZJU: Zhejiang University)H-Index: 3
#2Wen ZhangH-Index: 3
Last. Jianghua Chen (ZJU: Zhejiang University)H-Index: 16
view all 8 authors...
Importance Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) may have different effects on cardiovascular (CV) events in patients with diabetes mellitus (DM). Objective To conduct a meta-analysis to separately evaluate the effects of ACEIs and ARBs on all-cause mortality, CV deaths, and major CV events in patients with DM. Data Sources Data sources included MEDLINE (1966-2012), EMBASE (1988-2012), the Cochrane Central Register of Controlled Trials, conf...
143 CitationsSource
#1Ta-Wei Hsu (NYMU: National Yang-Ming University)H-Index: 3
#2Jia-Sin Liu (NHRI: National Health Research Institutes)H-Index: 7
Last. Der-Cherng Tarng (NYMU: National Yang-Ming University)H-Index: 31
view all 8 authors...
Importance The benefit of using a renin-angiotensin-aldosterone system blocker such as an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB) for patients with advanced chronic kidney disease (CKD) remains undetermined. Objective To assess the effectiveness and safety of ACEI/ARB use for advanced predialysis CKD in patients with hypertension and anemia. Design Prospective cohort study. Setting Taiwan. Participants From January 1, 2000, through June 30, 2009...
99 CitationsSource
#1Miklos Z. MolnarH-Index: 48
#2Kamyar Kalantar-Zadeh (UCI: University of California, Irvine)H-Index: 96
Last. Csaba P. Kovesdy (UTHSC: University of Tennessee Health Science Center)H-Index: 70
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Objectives The study objective was to assess the association between angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) use and mortality in patients with chronic kidney disease (CKD). Background There is insufficient evidence about the association of ACEI or ARBs with mortality in patients with CKD. Methods A logistic regression analysis was used to calculate the propensity of ACEI/ARB initiation in 141,413 U.S. veterans with nondialysis CKD who were previously un...
90 CitationsSource
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#1Elvira O. Gosmanova (Albany Medical College)H-Index: 12
#2Miklos Z. Molnar (Methodist University)H-Index: 3
Last. Kamyar Kalantar-Zadeh (UCI: University of California, Irvine)H-Index: 96
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Abstract Background Angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACEi/ARB) improve predialysis outcomes; however, ACEi/ARB are underutilized in patients transitioning to dialysis. We examined the association of different patterns of predialysis ACEi/ARB use with postdialysis survival, and whether potentially modifiable adverse events are associated with lower predialysis ACEi/ARB utilization. Methods This was a historic cohort study of 34,676 US veterans with, and ...
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#1Woldesellassie M. Bezabhe (UTAS: University of Tasmania)H-Index: 4
#2A Kitsos (UTAS: University of Tasmania)H-Index: 2
Last. Jan Radford (UTAS: University of Tasmania)H-Index: 3
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Background: Australian patients with chronic kidney disease (CKD) are routinely managed in general practices with multiple medications. However, no nationally representative study has evaluated the quality of prescribing in these patients. The objective of this study was to examine the quality of prescribing in patients with CKD using nationally representative primary care data obtained from the NPS MedicineWise’s dataset, MedicineInsight. Methods: A cross-sectional analysis of general practice ...
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#1Shin-Rong Lee (Yale University)
#2Haoran Zhuo (Yale University)
Last. Cassius Iyad Ochoa Chaar (Yale University)H-Index: 8
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Abstract Objective Postcontrast acute kidney injury (PC-AKI) is a dreaded complication of peripheral vascular interventions (PVIs) that depends on the volume of contrast administered as well as a patient's baseline kidney function. However, there is currently no guidance on the volume of contrast that is considered safe especially for patients with advanced chronic kidney disease (CKD). This study aims to characterize the incidence, risk factors for, and outcomes after PC-AKI and define threshol...
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#1Yao Qiao (Johns Hopkins University)
#1Yao Qiao (Johns Hopkins University)H-Index: 4
Last. Morgan E. Grams (Johns Hopkins University)H-Index: 37
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Abstract Objective To assess the patterns of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACE-I/ARB) discontinuation in the setting of chronic kidney disease (CKD) progression in real-world clinical practice. Patients and Methods We identified incident ACE-I/ARB users with a baseline estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m2 and without end-stage renal disease in the Geisinger Health System between January 1, 2004, and December 31, 2015. We inv...
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#1Hyeonjin Kang (SNU: Seoul National University)
#2Song Hee Hong (SNU: Seoul National University)H-Index: 1
Polypharmacy, the concurrent use of multiple medicines, could increase the risk of kidney dysfunction among older adults because it likely burdens the aging kidneys to excrete multiple pharmaceutical ingredients and their metabolites. This study aimed to examine the relation between polypharmacy and kidney dysfunction among older patients. A nested case-control study was conducted using the National Health Insurance Service – Senior Cohort (NHIS-SC, 2009–2013), representative of the Korean senio...
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#1Satoshi Higuchi (Kyorin University)H-Index: 4
#2Shun Kohsaka (Keio: Keio University)H-Index: 20
Last. Tsutomu YoshikawaH-Index: 36
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Abstract Purpose Although guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF) should be treated with renin-angiotensin system (RAS) inhibitors, the long-term efficacy of RAS inhibitors in HFrEF patients with moderate-to-severe chronic kidney disease (CKD) remains unclear. Methods The present study included consecutive patients hospitalized for acute heart failure across five Japanese teaching hospitals. The impact of RAS inhibitors on 2-year all-cause mor...
1 CitationsSource
RESUMO Estimativas sugerem que em torno de 20% a 30% dos obitos de pacientes com doenca renal cronica em estagio dialitico decorrem de renuncia a dialise, da interrupcao do tratamento dialitico ou da incapacidade de oferecer tratamento dialitico em funcao das condicoes locais. O envelhecimento populacional, o aumento das comorbidades associadas a doenca renal cronica e o nivel socioeconomico do pais contribuem para esse cenario. Em diversas ocasioes o nefrologista estara presente para intervir a...
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