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Use of ACEi and ARB associated with lower risk of renal failure in replacement therapy

Use of ACEi and ARB associated with lower risk of renal failure in replacement therapy
Use of ACEi and ARB associated with lower risk of renal failure in replacement therapy

MONDAY, July 8, 2024 (HealthDay News) — In people with advanced chronic kidney disease (CKD), treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) is associated with a reduced risk of kidney failure with replacement therapy (KFRT), but not death, according to a study published online July 2 in Annals of Internal Medicine.

Elaine Ku, MD, of the University of California, San Francisco, and colleagues examined the association between initiation of ACEi or ARB treatment and KFRT and death rates using data from completed randomized controlled trials from 1946 to December 31, 2023.

Data from 1,739 participants across 18 trials were included. Of these patients, 35.9 percent developed CFRT and 7.6 percent died during a median follow-up of 34 months. The researchers found that the risk of CFRT was lower with initiation of ACEi or ARB treatment (adjusted hazard ratio, 0.66; 95 percent confidence interval, 0.55 to 0.79), but the risk of death was not significantly lower (adjusted hazard ratio, 0.86; 95 percent confidence interval, 0.58 to 1.28). No significant interactions were found between ACEi or ARB treatment and age, estimated glomerular filtration rate, albuminuria, or diabetes.

“Initiation of ACEi or ARB therapy protects against CFRT but not death in people with advanced CKD,” the authors write. “Even at a time when other agents such as sodium-glucose cotransporter-2 inhibitors are available, initiation of ACEi or ARB treatment in patients with low glomerular filtration rate may provide substantial benefit.”

Several authors revealed connections to the pharmaceutical industry.

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