25 Feb Chronic Kidney Disease: ACEI/ARB Use and Survival Benefit

MedicalResearch.com Interview with:
Dr. Csaba P. Kovesdy, MD FASN
Clinical Associate Professor of Medicine
Chief of Nephrology, Salem VA Medical Center

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.

Citation:

Angiotensin-Converting Enzyme Inhibitor, Angiotensin Receptor Blocker Use, and Mortality in Patients With Chronic Kidney Disease

J Am Coll Cardiol. 2014 Feb 25;63(7):650-8. doi: 10.1016/j.jacc.2013.10.050. Epub 2013 Nov 21.

Molnar MZ¹, Kalantar-Zadeh K², Lott EH³, Lu JL⁴, Malakauskas SM⁵, Ma JZ⁶, Quarles DL⁴, Kovesdy CP⁷.

Last Updated on August 16, 2014 by Marie Benz MD FAAD