MedicalResearch.com: What are the main findings of the study?
Dr. Kovesdy: We describe significantly lower all-cause mortality rates in 141,413 non-dialysis dependent CKD (chronic kidney disease) patients who were de-novo users of ACEI/ARB.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Kovesdy: To the best of our knowledge this is the largest observational study examining the association of ACEI/ARB with mortality in CKD. These drugs are often poorly tolerated by this patient group due to hyperkalemia and effects on GFR. In spite of a high discontinuation rate in our study we still noted a survival benefit.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Kovesdy: It may be worth the extra effort to maintain patients on ACEI/ARB in cases when they develop hyperkalemia, which could be controlled by means other than discontinuation of these agents.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Kovesdy: It would be worthwhile examining the effects of ACEI/ARB on survival in clinical trials.