Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study
Joint Authors
Hsu, Wei-Fan
Hou, Ming-Chih
Huang, Yi-Hsiang
Yu, Shi-Hang
Wu, Jaw-Ching
Wu, Chun-Ying
Peng, Cheng-Yuan
Lin, Jaw-Town
Source
Gastroenterology Research and Practice
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-10-10
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
The use of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) carries a risk of renal function deterioration in cirrhotic patients with ascites.
However, whether the long-term use of ACEis/ARBs is safe in cirrhotic patients without ascites remains unknown.
Methods.
In this nationwide cohort study, we identified 311,361 newly diagnosed cirrhotic patients between January 1997 and December 2013.
To avoid indication and immortal time biases, patients receiving regular ACEi/ARB therapy, defined as the ACEi/ARB cohort, were matched to patients receiving regular calcium channel blockers (CCBs), defined as the CCB cohort, at a ratio of 1 : 1 by age, sex, and propensity scores for comorbidities and medications (2,188 patients in each cohort).
Cumulative incidence rates and multivariate analyses of end-stage renal disease (ESRD) risk were adjusted for competing mortality.
Results.
The 10-year cumulative incidence rates of ESRD were 2.32% (95% confidence interval [CI]: 1.45–3.20) in the ACEi/ARB cohort and 1.70% (95% CI: 1.03–2.36) in the CCB cohort (P=0.610).
In multivariate analyses, ACEi/ARB use was not associated with a higher risk of ESRD in cirrhotic patients (hazard ratio HR=1.15; 95% CI: 0.69–1.94, P=0.591).
In the sensitivity test, the 10-year cumulative incidence rates of ESRD in cirrhotic patients with ascites were 6.50% (95% CI: 0.54–12.46) and 1.24% (95% CI: 0.00–2.71) in ACEi/ARB and CCB cohorts, respectively (P=0.090).
Conclusions.
Long-term ACEi/ARB use was not associated with a higher risk of ESRD in cirrhotic patients.
However, the risk of ESRD tended to increase in cirrhotic patients with ascites.
American Psychological Association (APA)
Hsu, Wei-Fan& Yu, Shi-Hang& Lin, Jaw-Town& Wu, Jaw-Ching& Hou, Ming-Chih& Huang, Yi-Hsiang…[et al.]. 2019. Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study. Gastroenterology Research and Practice،Vol. 2019, no. 2019, pp.1-8.
https://search.emarefa.net/detail/BIM-1154836
Modern Language Association (MLA)
Hsu, Wei-Fan…[et al.]. Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study. Gastroenterology Research and Practice No. 2019 (2019), pp.1-8.
https://search.emarefa.net/detail/BIM-1154836
American Medical Association (AMA)
Hsu, Wei-Fan& Yu, Shi-Hang& Lin, Jaw-Town& Wu, Jaw-Ching& Hou, Ming-Chih& Huang, Yi-Hsiang…[et al.]. Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study. Gastroenterology Research and Practice. 2019. Vol. 2019, no. 2019, pp.1-8.
https://search.emarefa.net/detail/BIM-1154836
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1154836