Document Detail


ACE inhibitors and survival of hemodialysis patients.
MedLine Citation:
PMID:  12407648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular disease is a leading cause of death in patients with end-stage renal disease (ESRD). Hypertension is a major risk factor for cardiovascular complications in these patients. Angiotensin-converting enzyme (ACE) inhibitors are an effective treatment for hypertension in patients with ESRD and are known to improve prognosis in patients with chronic renal failure. We investigated their effect on mortality in patients undergoing long-term hemodialysis therapy. METHODS: Clinical data for patients on hemodialysis therapy between 1994 and 2000 were reviewed. Patients were grouped according to whether they had been treated with ACE inhibitors. RESULTS: Sixty patients had been treated with ACE inhibitors (treated group) and 66 patients had not (untreated group). Blood pressure reduction was not significantly different between the treated and untreated groups. Nevertheless, comparing the treated group with the untreated group, mortality was decreased significantly in the treated group, with a risk reduction of 52% (rate ratio [RR], 0.482; confidence interval [CI], 0.25 to 0.91; P < 0.0019). In treated patients 65 years or younger, the absolute risk reduction of mortality was 79% (RR, 0.211; CI, 0.08 to 0.58; P < 0.0006). CONCLUSION: Although further research is needed, these preliminary findings suggest that ACE inhibitors, independently of their antihypertensive effect, may dramatically reduce mortality among chronic hemodialysis patients 65 years or younger.
Authors:
Shai Efrati; Ronit Zaidenstein; Victor Dishy; Ilia Beberashvili; Moshe Sharist; Zhan Averbukh; Ahuva Golik; Joshua Weissgarten
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  40     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-30     Completed Date:  2002-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1023-9     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by the National Kidney Foundation, Inc.
Affiliation:
Department of Internal Medicine A, Assaf Harofeh Medical Center, Zerifin, Israel. efratishai@barak-online.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Cardiovascular Diseases / etiology,  mortality,  prevention & control
Female
Humans
Hypertension, Renal / complications,  drug therapy
Kidney Failure, Chronic / complications,  drug therapy,  mortality,  therapy
Male
Middle Aged
Renal Dialysis / methods,  mortality*
Survival Analysis
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections
Comment In:
Am J Kidney Dis. 2002 Nov;40(5):1100-2   [PMID:  12407658 ]
Am J Kidney Dis. 2003 Feb;41(2):520-1   [PMID:  12552520 ]

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