Angiotensin-converting enzyme inhibitors or angiotensin receptor blocker monotherapy retard deterioration of renal function in Taiwanese chronic kidney disease population

被引：13

作者：

Zheng, Cai-Mei ^{[1
,2
,3
]}

Wang, Jia-Yi ^{[4
,5
]}

Chen, Tzu-Ting ^{[6
,7
]}

Wu, Yun-Chun ^{[6
]}

Wu, Yi-Lien ^{[8
,9
]}

Lin, Hsin-Ting ^{[10
]}

Chiu, Sheng-Po ^{[4
,11
]}

Chang, Tian-Jong ^{[12
,13
]}

Zheng, Jing-Quan ^{[1
,14
]}

Chu, Nain-Feng ^{[15
,16
]}

Lin, Yu-Me ^{[17
]}

Su, Sui-Lung ^{[15
]}

Lu, Kuo-Cheng ^{[18
]}

Chen, Jin-Shuen ^{[19
]}

Sung, Fung-Chang ^{[20
]}

Lee, Chien-Te ^{[21
]}

Yang, Yu ^{[22
]}

Hwang, Shang-Jyh ^{[23
]}

Wang, Ming-Cheng ^{[24
]}

Hsu, Yung-Ho ^{[2
,3
]}

Chiou, Hung-Yi ^{[17
]}

Kao, Senyeong ^{[12
,15
]}

Wu, Mei-Yi ^{[2
,3
,6
,7
]}

Lin, Yuh-Feng ^{[1
,2
,3
,19
]}

机构：

[1] Taipei Med Univ, Coll Med, Grad Inst Clin Med, Taipei, Taiwan

[2] Taipei Med Univ, Coll Med, Sch Med, Dept Internal Med, Taipei, Taiwan

[3] Taipei Med Univ, Shuang Ho Hosp, Dept Internal Med, Div Nephrol, Taipei, Taiwan

[4] Taipei Med Univ, Coll Med, Grad Inst Med Sci, Taipei, Taiwan

[5] Taipei Med Univ, Coll Med, Dept Physiol, Taipei, Taiwan

[6] Natl Taiwan Univ, Coll Publ Hlth, Inst Epidemiol & Prevent Med, Taipei, Taiwan

[7] Taipei Med Univ, Shuang Ho Hosp, Dept Primary Care Med, Taipei, Taiwan

[8] Taipei Med Univ, Coll Nursing, Sch Nursing, Taipei, Taiwan

[9] Kidney Dis Prevent Fdn, Taipei, Taiwan

[10] Natl Def Med Ctr, Triserv Gen Hosp, Dept Ophthalmol, Taipei, Taiwan

[11] Natl Def Med Ctr Taipei, Triserv Gen Hosp, Dept Internal Med, Div Endocrinol & Metab,Songshan Branch, Taipei, Taiwan

[12] Natl Def Med Ctr, Grad Inst Life Sci, Taipei, Taiwan

[13] Taipei Med Univ, Shuang Ho Hosp, Performance Appraisal Sect, Secretary Off, Taipei, Taiwan

[14] Taipei Med Univ, Shuang Ho Hosp, Dept Crit Care Med, Taipei, Taiwan

[15] Natl Def Med Ctr, Sch Publ Hlth, Taipei, Taiwan

[16] Kaohsiung Vet Gen Hosp, Dept Med Educ & Res, Kaohsiung, Taiwan

[17] Taipei Med Univ, Coll Publ Hlth & Nutr, Sch Publ Hlth, Taipei, Taiwan

[18] Fu Jen Catholic Univ, Fu Jen Catholic Univ Hosp, Sch Med, Dept Med,Div Nephrol, Taipei, Taiwan

[19] Natl Def Med Ctr Taipei, Triserv Gen Hosp, Dept Med, Div Nephrol, Taipei, Taiwan

[20] China Med Univ, Sch Publ Hlth, Grad Inst Clin Med Sci, Taichung, Taiwan

[21] Chang Gung Med Univ, Kaohsiung Chang Gung Mem Hosp, Div Nephrol, Kaohsiung, Taiwan

[22] Changhua Christian Hosp, Div Nephrol, Changhua, Taiwan

[23] Kaohsiung Med Univ Hosp, Dept Med, Div Nephrol, Kaohsiung, Taiwan

[24] Cheng Kung Univ, Dept Internal Med, Div Nephrol, Med Ctr, Tainan, Taiwan

来源：

SCIENTIFIC REPORTS | 2019年 / 9卷 / 1期

关键词：

RANDOMIZED CONTROLLED-TRIAL; BLOOD-PRESSURE CONTROL; DIABETIC-NEPHROPATHY; COMBINATION THERAPY; PROTEINURIA REDUCTION; ACE-INHIBITION; PROGRESSION; RISK; SYSTEM; METAANALYSIS;

D O I：

10.1038/s41598-019-38991-z

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

It remains unclear how different uses of angiotensin-converting inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) influence the progression of chronic kidney disease (CKD). This study explored CKD progression in a multicentre, longitudinal cohort study that included 2639 patients with CKD stage 1-5 and hypertension. Patients treated with ACEI or ARB for >= 90 days during a 6-mo period comprised the study group, or no treatment, comprised the control group. The study group was subdivided on the basis of treatment: ACEI monotherapy or ARB monotherapy. Progression of renal deterioration was defined by an average eGFR decline of more than 5 mL/min/1.73 m(2)/yr or the commencement of dialysis. With at least 1-year follow up, a progression of renal deterioration was demonstrated in 29.70% of the control group and 25.09% of the study group. Patients in the study group had significantly reduced progression of CKD with adjusted odds ratio 0.79 (95% confidence interval: 0.63-0.99). However, when ACEI monotherapy and ARB monotherapy were analyzed separately, none of their associations with CKD progression was statistically significant. In conclusion, ACEI or ARB monotherapy may retard the deterioration of renal function among patients with CKD and hypertension.

引用

页数：9

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