ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients
| Autor: | Ning Su, Xiaoyang Wang, Xiaojiang Zhan, Fenfen Peng, Yujing Zhang, Yueqiang Wen, Jianbo Liang, Xianfeng Wu, Qian Zhou, Liya Zhu, Zebin Wang, Lingling Liu, Xiaoran Feng, Mengmeng Li, Yuxin Xie, Yingsi Zeng, Xingming Tang |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding Physiology medicine.medical_treatment Subgroup analysis Angiotensin-Converting Enzyme Inhibitors Lower risk Peritoneal dialysis Angiotensin Receptor Antagonists Physiology (medical) Internal medicine Medicine Humans cardiovascular diseases Retrospective Studies business.industry Proportional hazards model Incidence (epidemiology) Incidence Confounding medicine.disease Nephrology Propensity score matching business Gastrointestinal Hemorrhage Peritoneal Dialysis |
| Zdroj: | Clinical and experimental nephrology. 26(3) |
| ISSN: | 1437-7799 |
| Popis: | Background Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknown. Methods Overall, 734 PD patients were enrolled after using propensity score matching. Kaplan-Meier analysis and COX regression were used to explore correlation between ACEi/ARBs and GIB. Competitive risk model was aimed to identify whether other events were confounding factors. Forest plot was applied to assess the influence of ACEI/ARBs on GIB incidence in different groups. Results During 8-year follow-up, 89 (12.13%) cases of GIB were recorded. Kaplan-Meier analysis revealed that the incidence of GIB among patients taking ACEi/ARBs was lower than those subjects who had not (log rank = 6.442, P = 0.011). After adjusted different confounding factors, administration of ACEi/ARBs was associated with lowered GIB incidence (adjusted HR = 0.49, 95% CI 0.32-0.77, P = 0.002). In competitive risk model, considering of other events, the incidence of GIB in two groups was still statistically significant (P = 0.010). Subgroup analysis showed ACEi/ARBs taking impeded GIB in the ≥ 60 age group (HR = 0.52, 95% CI 0.28-0.98, P = 0.040). Conclusion PD patients who were submitted to ACEi/ARBs inclined to have a lower risk for GIB. In this regard, ACEi/ARBs offered a promising choice to GIB. |
| Databáze: | OpenAIRE |
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