Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Do the Benefits of Medications Outweigh the Burdens for Hemodialysis Patients?: Comment on “Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers and Cardiovascular Outcomes in Chronic Dialysis Patients”

Do the Benefits of Medications Outweigh the Burdens for Hemodialysis Patients?: Comment on “Use... A recent study reported that patients on hemodialysis are prescribed an average of 11 different medications with a mean daily burden of 19 pills.1 Yet few randomized controlled trials support the efficacy of these medications in the dialysis population, in part because these patients are usually excluded from trials. Angiotensin converting enzyme inhibitors are commonly used in the dialysis population to control hypertension and heart failure; lisinopril was the seventh most commonly prescribed drug among hemodialysis patients in the United States in 2008, according to the 2011 Annual Data Report from the United States Renal Data System.2 Thus, the “real world” data reported by Bajaj et al,which suggest that ACEIs might not provide the benefits to dialysis patients that have been demonstrated among non–dialysis-dependent patients, are particularly relevant despite the limitations of observational data. Their results serve to highlight the need for more randomized trials to determine whether the burdens and the costs of the medications prescribed to these patients are warranted. References 1. Chiu YW, Teitelbaum I, Misra M, de Leon EM, Adzize T, Mehrotra R. Pill burden, adherence, hyperphosphatemia, and quality of life in maintenance dialysis patients. Clin J Am Soc Nephrol. 2009;4(6):1089-109619423571PubMedGoogle ScholarCrossref 2. US Renal Data System. USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Do the Benefits of Medications Outweigh the Burdens for Hemodialysis Patients?: Comment on “Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers and Cardiovascular Outcomes in Chronic Dialysis Patients”

Archives of Internal Medicine , Volume 172 (7) – Apr 9, 2012

Loading next page...
 
/lp/american-medical-association/do-the-benefits-of-medications-outweigh-the-burdens-for-hemodialysis-HcyugAG0mB
Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.172.7.593
Publisher site
See Article on Publisher Site

Abstract

A recent study reported that patients on hemodialysis are prescribed an average of 11 different medications with a mean daily burden of 19 pills.1 Yet few randomized controlled trials support the efficacy of these medications in the dialysis population, in part because these patients are usually excluded from trials. Angiotensin converting enzyme inhibitors are commonly used in the dialysis population to control hypertension and heart failure; lisinopril was the seventh most commonly prescribed drug among hemodialysis patients in the United States in 2008, according to the 2011 Annual Data Report from the United States Renal Data System.2 Thus, the “real world” data reported by Bajaj et al,which suggest that ACEIs might not provide the benefits to dialysis patients that have been demonstrated among non–dialysis-dependent patients, are particularly relevant despite the limitations of observational data. Their results serve to highlight the need for more randomized trials to determine whether the burdens and the costs of the medications prescribed to these patients are warranted. References 1. Chiu YW, Teitelbaum I, Misra M, de Leon EM, Adzize T, Mehrotra R. Pill burden, adherence, hyperphosphatemia, and quality of life in maintenance dialysis patients. Clin J Am Soc Nephrol. 2009;4(6):1089-109619423571PubMedGoogle ScholarCrossref 2. US Renal Data System. USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 9, 2012

Keywords: angiotensin-converting enzyme inhibitors,hemodialysis,angiotensin receptor antagonists,cardiovascular system

References