ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO905

Outcomes Differences in User vs. Non-User of Renin-Angiotensin Blockers in Early CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Prasad, Narayan, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Kundu, Monica, The George Institute for Global Health India, New Delhi, Delhi, India
  • Yadav, Ashok Kumar, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
  • Kumar, Vivek, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
  • Jha, Vivekanand, The George Institute for Global Health India, New Delhi, Delhi, India

Group or Team Name

  • Indian Chronic Kidney Disease Study Group
Background

Renin-angiotensin-aldosterone-system blockers (RASB) are the antihypertensive drug class of choice in patients with CKD. There are few head-to-head comparisons of the renal or nonrenal outcomes between RASB users and non-users. We aimed to compare the renal and cardiovascular outcomes between the two in patients enrolled in the Indian Chronic Kidney Disease (ICKD) Study.

Methods

A total of 4050 patients with mild-moderate CKD recruited in the ICKD cohort were studied. Patients were categorized as ARB users or nonusers. The renal outcomes [50% decline in eGFR and end stage kidney disease (ESKD)], all-cause mortality, and cardiovascular mortality was analysed over a median follow up period of 2.65 (1.40, 3.89) years between RASB users and nonusers.

Results

Out of a total of 4056 patients, 3487 (86%) were hypertensive. A total of 82 (89%) out of 92 in stage 1, 192 (70%) out of 275 in stage 2, 1677 (61%) out of 2742 in stage 3 and 154 (41%) out of 378 in stage 4 hypertensive patients received RASBs. The rate of decline of eGFR in RASB user was numerically low as compared to non-users (Figure 1). The adjusted hazard ratio (HR) for RASB user for a 50% decline in eGFR, ESKD, all-cause mortality and cardiovascular mortality was 0.72, 0.72, 0.59, and 0.48 respectively (Figure 2).

Conclusion

The use of RASBs decreased with advancing CKD stages from stage 1 to 4. RASB use is associated with slower rate of decline in eGFR in those with CKD stage 1-3. RASB users had a significantly lower risk of all-cause mortality and cardiovascular mortality

Funding

  • Government Support – Non-U.S.