Renin-angiotensin system blockers and residual kidney function loss in patients initiating peritoneal dialysis: an observational cohort study

Autor: Jenny I. Shen, Anjali B. Saxena, Sitaram Vangala, Satvinder K. Dhaliwal, Wolfgang C. Winkelmayer
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: BMC Nephrology, Vol 18, Iss 1, Pp 1-10 (2017)
Druh dokumentu: article
ISSN: 1471-2369
DOI: 10.1186/s12882-017-0616-4
Popis: Abstract Background Although angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) have been shown to preserve residual kidney function in a select group of Asian patients undergoing continuous ambulatory peritoneal dialysis (PD) in two small randomized clinical trials, the effectiveness of these drugs has yet to be demonstrated in a more diverse population of patients with multiple comorbid conditions. We investigated the association between ACEI/ARB use and development of recorded anuria in a cohort of patients initiating PD in the U.S. Methods We conducted a retrospective observational cohort study using the US Renal Data System and electronic health records data from a large national dialysis provider. We identified adult patients who initiated PD from 2007 to 2011. Only patients who participated in the federal prescription drug benefit program, Medicare Part D, for the first 90 days of dialysis were included. Patients who filled a prescription for an ACEI or ARB during those 90 days were considered users. We applied Cox proportional hazards models to an inverse probability of treatment-weighted (IPTW) cohort to estimate the hazard ratio (HR) for anuria (24-h urine volume
Databáze: Directory of Open Access Journals