Kidney Week

Abstract: TH-PO381

Renin-Angiotensin System Blockade and Mortality in Peritoneal Dialysis Patients

Session Information

• Dialysis: Peritoneal Dialysis - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Hernandez Gonzalez, Godhy Eli, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Godhy Eli Hernandez Gonzalez,

• Soto-Vargas, Javier, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Javier Soto-Vargas,

• Arellano-Mendez, Denisse, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Denisse Arellano-Mendez,

• Delgado-Ayon, Omar Ignacio, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Omar Ignacio Delgado-Ayon,

• Jiménez Mejía, Carlos Daniel, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Carlos Daniel Jiménez Mejía,

• Pazarin-Villaseñor, Leonardo, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Leonardo Pazarin-Villaseñor,

• Parra Michel, Renato, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Renato Parra Michel,

• Gutierrez-Prieto, Julio Alejandro, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en Nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, JALISCO, Mexico

Julio Alejandro Gutierrez-Prieto,

Background

Renin-Angiotensin System (RAS) blockade in Peritoneal dialysis (PD) patients has not been widely examined, however, its use in hemodialysis (HD) patients has been associated with risk reduction in all-cause and cardiovascular mortality. Moreover, mortality in PD patients still represents a challenge for the clinician. Our objective was to determine if RAS blockade improve survival or reduce all-cause mortality in PD patients.

Methods

A total of 248 adult PD patients were prospectively enrolled from January to October 2017. The preliminary findings of 85 patients are presented here. Sixty-four (75%) with RAS blockade and 21 (25%) without it were analysed. The mean follow-up was 13.5±3.4 months. We performed a survival and multivariate analysis adjusted for age, gender and diabetes mellitus, between groups to estimate the all-cause mortality risk.

Results

The median age was 42 years (IQR 27-62) and 64 (74.4%) were male. There were no significant differences in baseline characteristics between groups (e.g. residual renal function, etiology of CKD, comorbidities, type of peritoneal transport and dyslipidemia profile). Four deaths were recorded during follow-up, one (1.6%) in the RAS blockade group and 3 (14.3%) in the control group (p=0.02). Patients with RAS blockade had higher serum potassium (p =0.01) as well as reduced risk for all-cause mortality compared with the group without RAS blockade (OR 0.05, CI 95% 0.03-0.85, p=0.04) in the multivariate analysis.

Conclusion

In this prospective cohort of PD patients, the use of RAS blockers was associated with all-cause mortality risk reduction and higher serum potassium.