Should We STOP Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers in Advanced Kidney Disease?

被引：37

作者：

Ahmed, Aimun ^{[1
]}

Jorna, Tom ^{[2
,3
]}

Bhandari, Sunil ^{[2
,3
]}

机构：

[1] Royal Preston Hosp, Lancashire Teaching Hosp, Renal Dept, Preston, Lancs, England

[2] Hull & East Yorkshire Hosp NHS Trust, Kingston Upon Hull HU3 2JZ, Yorks, England

[3] Hull York Med Sch, Kingston Upon Hull HU3 2JZ, Yorks, England

来源：

NEPHRON | 2016年 / 133卷 / 03期

关键词：

Chronic kidney disease; Angiotensin-converting enzyme inhibitor; Angiotensin receptor blocker; CHRONIC HEART-FAILURE; STAGE RENAL-DISEASE; ALL-CAUSE MORTALITY; VENTRICULAR SYSTOLIC FUNCTION; TYPE-2; DIABETIC-NEPHROPATHY; GLOMERULAR-FILTRATION-RATE; BLOOD-PRESSURE CONTROL; POST-HOC ANALYSIS; CARDIOVASCULAR-DISEASE; RANDOMIZED-TRIAL;

D O I：

10.1159/000447068

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD) and impaired quality of life. Previous research for preventing loss of glomerular filtration rate (GFR) has focused on reducing blood pressure (BP) and proteinuria. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor antagonists (ARB) are commonly used in patients with early CKD, but their value in advanced CKD (estimated GFR (eGFR) <= 30 ml/min/1.73 m(2)) is unknown. There remains a debate about the omission of ACEi/ARB in patients with advanced CKD and their use in association with CVD or heart failure. Does the potential gain in eGFR with ACEi/ARB cessation outweigh the potential adverse cardiovascular outcomes? This paper reviews the current literature that addresses this issue. Several controversies are discussed. Although lowering BP reduces cardiovascular events, evidence suggests that ACEi/ARBs are not superior to other antihypertensive agents. There are no studies assessing the benefits of ACEi/ARB therapy in cardiovascular risk reduction in advanced non-dialysis CKD. The STOP ACEi trial will strengthen the evidence base and shed light on the potential merits and dangers of ACEi/ARB use in advanced CKD on renal function and cardiovascular outcomes. (C) 2016 S. Karger AG, Basel

引用

页码：147 / 158

页数：12

共 88 条

[1] Blood pressure lowering and major cardiovascular events in people with and without chronic kidney disease: meta-analysis of randomised controlled trials [J].

Agodoa, L. ;

Anderson, C. ;

Asselbergs, F. W. ;

Baigent, C. ;

Black, H. ;

Brenner, B. ;

Brown, M. ;

Bulpitt, C. ;

Byington, R. ;

Chalmers, J. ;

Collins, R. ;

Cutler, J. ;

Dahlof, B. ;

Davis, B. ;

de Zeeuw, D. ;

Dens, J. ;

Estacio, R. ;

Fagard, R. ;

Fox, K. ;

Fukui, T. ;

Hansson, L. ;

Holman, R. ;

Hunsicker, L. ;

Imai, Y. ;

Ishii, M. ;

Kanno, Y. ;

Kostis, J. ;

Kuramoto, K. ;

Lewis, E. ;

Lievre, M. ;

Lindholm, L. H. ;

Liu, L. ;

Lubsen, J. ;

Lueders, S. ;

MacMahon, S. ;

Malacco, E. ;

Mancia, G. ;

Matsuzaki, M. ;

Neal, B. ;

Nissen, S. ;

Ohkubo, T. ;

Ogihara, T. ;

Pepine, C. ;

Pfeffer, M. ;

Pitt, B. ;

Poole-Wilson, P. ;

Poulter, N. ;

Rahman, M. ;

Remme, W. ;

Remuzzi, G. .

BMJ-BRITISH MEDICAL JOURNAL, 2013, 347

[2] The impact of stopping inhibitors of the renin-angiotensin system in patients with advanced chronic kidney disease [J].

Ahmed, Aimun K. ;

Kamath, Neetha S. ;

El Kossi, Mohsen ;

El Nahas, A. Meguid .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2010, 25 (12) :3977-3982

[3]

[Anonymous], CHRON KIDN DIS EARL

[4] Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease [J].

Appel, Lawrence J. ;

Wright, Jackson T., Jr. ;

Greene, Tom ;

Agodoa, Lawrence Y. ;

Astor, Brad C. ;

Bakris, George L. ;

Cleveland, William H. ;

Charleston, Jeanne ;

Contreras, Gabriel ;

Faulkner, Marquetta L. ;

Gabbai, Francis B. ;

Gassman, Jennifer J. ;

Hebert, Lee A. ;

Jamerson, Kenneth A. ;

Kopple, Joel D. ;

Kusek, John W. ;

Lash, James P. ;

Lea, Janice P. ;

Lewis, Julia B. ;

Lipkowitz, Michael S. ;

Massry, Shaul G. ;

Miller, Edgar R. ;

Norris, Keith ;

Phillips, Robert A. ;

Pogue, Velvie A. ;

Randall, Otelio S. ;

Rostand, Stephen G. ;

Smogorzewski, Miroslaw J. ;

Toto, Robert D. ;

Wang, Xuelei .

NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (10) :918-929

[5] The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial [J].

Baigent, Colin ;

Landray, Martin J. ;

Reith, Christina ;

Emberson, Jonathan ;

Wheeler, David C. ;

Tomson, Charles ;

Wanner, Christoph ;

Krane, Vera ;

Cass, Alan ;

Craig, Jonathan ;

Neal, Bruce ;

Jiang, Lixin ;

Hooi, Lai Seong ;

Levin, Adeera ;

Agodoa, Lawrence ;

Gaziano, Mike ;

Kasiske, Bertram ;

Walker, Robert ;

Massy, Ziad A. ;

Feldt-Rasmussen, Bo ;

Krairittichai, Udom ;

Ophascharoensuk, Vuddidhej ;

Fellstrom, Bengt ;

Holdaas, Hallvard ;

Tesar, Vladimir ;

Wiecek, Andrzej ;

Grobbee, Diederick ;

de Zeeuw, Dick ;

Gronhagen-Riska, Carola ;

Dasgupta, Tanaji ;

Lewis, David ;

Herrington, William ;

Mafham, Marion ;

Majoni, William ;

Wallendszus, Karl ;

Grimm, Richard ;

Pedersen, Terje ;

Tobert, Jonathan ;

Armitage, Jane ;

Baxter, Alex ;

Bray, Christopher ;

Chen, Yiping ;

Chen, Zhengming ;

Hill, Michael ;

Knott, Carol ;

Parish, Sarah ;

Simpson, David ;

Sleight, Peter ;

Young, Alan ;

Collins, Rory .

LANCET, 2011, 377 (9784) :2181-2192

[6] Diabetes mellitus as a compelling indication for use of renin angiotensin system blockers: systematic review and meta-analysis of randomized trials [J].

Bangalore, Sripal ;

Fakheri, Robert ;

Toklu, Bora ;

Messerli, Franz H. .

BMJ-BRITISH MEDICAL JOURNAL, 2016, 352

[7] Multicentre randomized controlled trial of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker withdrawal in advanced renal disease: the STOP-ACEi trial [J].

Bhandari, Sunil ;

Ives, Natalie ;

Brettell, Elizabeth A. ;

Valente, Marie ;

Cockwell, Paul ;

Topham, Peter S. ;

Cleland, John G. ;

Khwaja, Arif ;

El Nahas, Meguid .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2016, 31 (02) :255-261

[8] Risk factors and metabolic mechanisms in the pathogenesis of uraemic cardiac disease [J].

Bhandari, Sunil .

FRONTIERS IN BIOSCIENCE-LANDMARK, 2011, 16 :1364-1387

[9] Examining Determinants of Patient Outcome in a Low Clearance Clinic [J].

Bhatia, Raghav T. ;

Browne, Oliver T. ;

Naudeer, Sarah ;

Allgar, Victoria ;

Bhandari, Sunil .

NEPHRON, 2015, 129 (04) :263-268

[10] Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis [J].

Black, C. ;

Sharma, P. ;

Scotland, G. ;

McCullough, K. ;

McGurn, D. ;

Robertson, L. ;

Fluck, N. ;

MacLeod, A. ;

McNamee, P. ;

Prescott, G. ;

Smith, C. .

HEALTH TECHNOLOGY ASSESSMENT, 2010, 14 (21) :1-+

← 1 2 3 4 5 6 7 8 9 →