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ACE-Inhibitors and ARBs Associated with Reduced Need for Dialysis in Advanced CKD — Physician’s First Watch

Medical News |
December 17, 2013

ACE-Inhibitors and ARBs Associated with Reduced Need for Dialysis in Advanced CKD

By Kelly Young

Use of either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) — but not the two together — may reduce the need for dialysis in patients with advanced chronic kidney disease, a JAMA Internal Medicine study finds.

Researchers in Taiwan studied antihypertensive use among roughly 28,000 patients who had predialysis stage 5 CKD, hypertension, and anemia.

During a median 7 months' follow-up, patients taking ACE-inhibitors or ARBs had a lower likelihood of long-term dialysis (hazard ratio, 0.94) and the composite outcome of dialysis or death (HR, 0.94), compared with nonusers. Concomitant ACE-inhibitor/ARB use wasn't associated with risk reduction. Hospitalization for hyperkalemia was more common among ACE-inhibitor/ARB users than nonusers (9.2% vs. 6.7%).

Commentators write: "For selected patients with no history of severe hyperkalemia or prior repeated episodes of acute kidney injury and with good adherence to laboratory monitoring, clinicians may elect to continue [renin-angiotensin-aldosterone system] blockade even in advanced CKD in an effort to delay the onset of end-stage renal disease."

Reader Comments (1)

ALAA ETMAN MD Physician, Cardiology, National Heart Institute, Governmental institute

Agree totally with the importance of antiRAAS in CKD, my consern is which one of antiRAAS, superior of each other or less risky to use

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