TY - JOUR
AU1 - Georgianos, Panagiotis I
AU2 - Tziatzios, Georgios
AU3 - Roumeliotis, Stefanos
AU4 - Vaios, Vasilios
AU5 - Sgouropoulou, Vasiliki
AU6 - Tsalikakis, Dimitrios G
AU7 - Liakopoulos, Vassilios
AU8 - Agarwal, Rajiv
AB - ABSTRACTBackgroundAngiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) are recommended by guidelines as first-line antihypertensive therapies in the general population or in patients with earlier stages of kidney disease. However, the cardioprotective benefit of these agents among patients on dialysis remains uncertain.MethodsWe searched the MEDLINE, PubMed and Cochrane databases from inception through February 2022 to identify randomized controlled trials (RCTs) comparing the efficacy of ACEIs/ARBs relative to placebo or no add-on treatment in patients receiving dialysis. RCTs were eligible if they assessed fatal or non-fatal cardiovascular events as a primary efficacy endpoint.ResultsWe identified five RCTs involving 1582 dialysis patients. Compared with placebo or no add-on treatment, the use of ACEIs/ARBs was not associated with a significantly lower risk of cardiovascular events {risk ratio [RR] 0.79 [95% confidence interval (CI) 0.57–1.11]}. Furthermore, there was no benefit in cardiovascular mortality [RR 0.82 (95% CI 0.59–1.14)] and all-cause mortality [RR 0.86 (95% CI 0.64–1.15)]. These results were consistent when the included RCTs were stratified by subgroups, including hypertension, ethnicity, sample size, duration of follow-up and quality.ConclusionThe present meta-analysis showed that among patients on dialysis, the use of ACEIs/ARBs is not associated with a significantly lower risk of cardiovascular events and all-cause mortality as compared with placebo or no add-on treatment.
TI - Effect of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on cardiovascular outcomes in dialysis patients: a systematic review and meta-analysis
JF - Nephrology Dialysis Transplantation
DO - 10.1093/ndt/gfac253
DA - 2022-09-07
UR - https://www.deepdyve.com/lp/oxford-university-press/effect-of-angiotensin-converting-enzyme-inhibitors-or-angiotensin-1juwHKY0q9
SP - 203
EP - 211
VL - 38
IS - 1
DP - DeepDyve
ER -