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Erschienen in: Clinical and Experimental Nephrology 3/2016

24.10.2015 | Original Article

Impact of use of angiotensin II receptor blocker on all-cause mortality in hemodialysis patients: prospective cohort study using a propensity-score analysis

verfasst von: Marenao Tanaka, Tomohisa Yamashita, Masayuki Koyama, Norihito Moniwa, Kohei Ohno, Kaneto Mitsumata, Takahito Itoh, Masato Furuhashi, Hirofumi Ohnishi, Hideaki Yoshida, Kazufumi Tsuchihashi, Tetsuji Miura, BOREAS HD study Investigators

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 3/2016

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Abstract

Background

It is controversial whether treatment with an angiotensin II receptor blocker (ARB) or a calcium channel blocker (CCB) improves prognosis of hemodialysis (HD) patients.

Methods

This study was designed as a multicenter prospective cohort study. HD patients (n = 1071) were enrolled from 22 institutes in January 2009 and followed up for 3 years. Patients with missing data, kidney transplantation or retraction of consent during the follow-up period (n = 204) were excluded, and 867 patients contributed to analysis of mortality. Propensity score (PS) for use of ARB and that for CCB was calculated using a multiple logistic regression model.

Results

ARB and CCB were prescribed in 45.6 and 54.7 % of patients at enrollment. During the 3-year follow-up period, all-cause mortality and cardiovascular mortality rates were 18.8 and 5.1 %, respectively. Kaplan–Meier curves showed that all-cause and cardiovascular mortality rates were lower in the ARB group than in the non-ARB group, though the mortality rates were similar in the CCB group and non-CCB group. In PS-stratified Cox regression analysis, ARB treatment was associated with 34 and 45 % reduction of all-cause death and cardiovascular death, respectively. In PS matching analysis, ARB treatment was associated with a significant reduction (46 % reduction) in the risk of all-cause death. A significant impact of CCB treatment on all-cause or cardiovascular mortality was not detected in PS analysis.

Conclusions

The use of an ARB, but not a CCB, is associated with reduced all-cause and cardiovascular mortalities in patients on HD.
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Metadaten
Titel
Impact of use of angiotensin II receptor blocker on all-cause mortality in hemodialysis patients: prospective cohort study using a propensity-score analysis
verfasst von
Marenao Tanaka
Tomohisa Yamashita
Masayuki Koyama
Norihito Moniwa
Kohei Ohno
Kaneto Mitsumata
Takahito Itoh
Masato Furuhashi
Hirofumi Ohnishi
Hideaki Yoshida
Kazufumi Tsuchihashi
Tetsuji Miura
BOREAS HD study Investigators
Publikationsdatum
24.10.2015
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 3/2016
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-015-1182-3

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