Document Detail


Anti-renin-angiotensin-system drugs and development of anemia in chronic kidney disease.
MedLine Citation:
PMID:  16299686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A variable inhibition of erythropoiesis has been reported in uremic patients with renal anemia receiving anti-renin-angiotensin-system (RAS) drugs (angiotensin-converting-enzyme inhibitors, and angiotensin-receptor-antagonists). The time to development of renal anemia before dialysis is still unknown. METHODS: A retrospective cohort study (1 to 15 years) on records of 327 out-patients (217 males, 110 females) without anemia and with chronic renal insufficiency (creatinine clearance 16 to 75 mL/min) was conducted to estimate the time to development of renal anemia (Hb < 11.5 g/dL in females and Hb < 12.5 g/dL in men), and the time to decrease of Hb by 1 and 2 g/dL or more, irrespective of anemia development. Two treatment groups were analyzed: 142 patients with, and 185 without anti-RAS drugs. RESULTS: Median survival time to development of anemia was 81 months, 59 months to the loss of Hb > 1 g/dL, and 94 months for the loss of Hb > 2 g/dL. Anemia developed significantly earlier in patients with initial Ccr < 40 mL/min and in those with initial Hb < 14 g/dL. In the multivariate analysis (Cox model), male gender, Ccr < 40 mL/min, and Hb < 14 g/dL, in increasing order of relative risk, significantly contributed to prediction of anemia development without any influence of the treatment with anti-RAS drugs. The same results were obtained considering survival to the loss of either Hb > 1 g/dL or Hb > 2 g/dL. CONCLUSIONS: Development of renal anemia in mild to severe chronic kidney disease is not influenced by treatment with anti-RAS drugs.
Authors:
Antonio Piccoli; Giordano Pastori; Erika Pierobon; Serena Torraca; Michele Andreucci; Massimo Sabbatini; Bruno Cianciaruso
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of nephrology     Volume:  18     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-11-21     Completed Date:  2006-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  585-91     Citation Subset:  IM    
Affiliation:
Department of Medical and Surgical Sciences, Nephrology Clinic, University of Padua--Italy. apiccoli@unipd.it
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MeSH Terms
Descriptor/Qualifier:
Anemia / chemically induced*
Angiotensin-Converting Enzyme Inhibitors / adverse effects*
Cohort Studies
Erythropoiesis / drug effects
Female
Humans
Kidney Failure, Chronic / complications*
Male
Middle Aged
Receptors, Angiotensin / antagonists & inhibitors*
Renin-Angiotensin System / drug effects*
Retrospective Studies
Survival Analysis
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Receptors, Angiotensin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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