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

• Published in: Scientific reports Vol. 9; no. 1; p. 2694
• Main Authors: Zheng, Cai-Mei, Wang, Jia-Yi, Chen, Tzu-Ting, Wu, Yun-Chun, Wu, Yi-Lien, Lin, Hsin-Ting, Chiu, Sheng-Po, Chang, Tian-Jong, Zheng, Jing-Quan, Chu, Nain-Feng, Lin, Yu-Me, Su, Sui-Lung, Lu, Kuo-Cheng, Chen, Jin-Shuen, Sung, Fung-Chang, Lee, Chien-Te, Yang, Yu, Hwang, Shang-Jyh, Wang, Ming-Cheng, Hsu, Yung-Ho, Chiou, Hung-Yi, Kao, Senyeong, Wu, Mei-Yi, Lin, Yuh-Feng
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 25.02.2019; Nature Publishing Group
• Subjects: 692/4022/1585/104/1586; 692/700/1719; Aged; Angiotensin; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-converting enzyme inhibitors; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Dialysis; Epidermal growth factor receptors; Female; Glomerular Filtration Rate - drug effects; Health risk assessment; Humanities and Social Sciences; Humans; Hypertension; Hypertension - blood; Hypertension - drug therapy; Hypertension - physiopathology; Kidney - drug effects; Kidney - metabolism; Kidney diseases; Longitudinal Studies; Male; Middle Aged; multidisciplinary; Odds Ratio; Patients; Peptidyl-dipeptidase A; Phosphates - blood; Prospective Studies; Renal function; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - physiopathology; Science; Science (multidisciplinary); Statistical analysis; Taiwan; Triglycerides - blood; Taiwan
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-38991-z

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.