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Abstract: TH-PO0307

Effects of Angiotensin Receptor Blockers on Cardiovascular Events and Kidney Function Among Patients on Dialysis: A Meta-Analysis

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Shafiq, Ihtesham, University of Tennessee Health Science Centre, Memphis, Tennessee, United States
  • Wall, Barry M., University of Tennessee Health Science Centre, Memphis, Tennessee, United States
  • Hastings, Margaret Colleen, University of Tennessee Health Science Centre, Memphis, Tennessee, United States
  • Vo, Hieu Q., University of Tennessee Health Science Centre, Memphis, Tennessee, United States
  • Adeboye, Adedamola M., University of Tennessee Health Science Centre, Memphis, Tennessee, United States
  • Ramrattan, Amit, University of Tennessee Health Science Centre, Memphis, Tennessee, United States
Background

Chronic kidney disease (CKD) affects over 800 million people globally, with end-stage renal disease (ESRD) patients on dialysis at high risk for cardiovascular events. Angiotensin receptor blockers (ARBs) have emerged as a potential therapy to reduce cardiovascular risk in dialysis patients, but their efficacy remains unclear.

Methods

A systematic review and meta-analysis of randomized controlled trials and cohort studies was conducted, evaluating the effects of ARBs on cardiovascular events and renal function in dialysis patients. Primary outcomes included changes in blood pressure, cardiovascular events, all-cause mortality, and renal function measures.

Results

Eleven studies with 45,290 dialysis patients were included. ARBs significantly reduced systolic blood pressure (mean difference -2.67 mmHg, 95% CI -3.84 to -1.49), diastolic blood pressure (-1.74 mmHg, 95% CI -2.86 to -0.62), and urine protein excretion (-0.52 g/d, 95% CI -1.52 to 0.49) compared to placebo. ARBs were associated with lower odds of cardiovascular events (OR 0.50, 95% CI 0.38 to 0.65) and all-cause mortality (RR 0.90, 95% CI 0.84 to 0.98). No significant differences were found for adverse events, residual GFR, or serum creatinine.

Conclusion

ARBs appear effective for reducing blood pressure and proteinuria in dialysis patients, with potential mortality benefits. However, their effects on cardiovascular events and renal function remain unclear. More extensive trials are needed to determine the optimal use of ARBs in this high-risk population.

Digital Object Identifier (DOI)