Using Blood Pressure Meds to Treat Kidney Disease

Antihypertensives delayed the need for dialysis in some advanced kidney disease patients

(RxWiki News) People with advanced kidney disease sometimes must undergo dialysis, during which waste is filtered from the blood. Certain drugs may delay the need for dialysis.

A recent study tested ACEIs and ARBs, two drugs used to lower blood pressure, on patients with advanced kidney disease.

They found that the patients who took the drugs were less likely to need dialysis or die during the follow-up period.

The authors of the study suggested that ACEI/ARB therapy may be an effective treatment for some kidney disease patients.

"If you have advanced kidney disease, talk to your doctor about treatment options."

Chih-Cheng Hsu, MD, DrPH, of the Division of Geriatrics and Gerontology in the Institute of Population Health Sciences, National Health Research Institutes, led the study.

According to the authors of the study, previous research has shown that the ACEI and ARB classes of drugs delay the progression of chronic kidney disease.

ACEI and ARB drugs are used to treat high blood pressure, in part by making blood vessels larger.

However, few trials have investigated the effects of ACEIs and ARBs on patients with advanced chronic kidney disease who are not on dialysis — a medical process that removes waste from the blood when kidneys stop functioning.

The researchers selected 28,497 patients with high blood pressure, anemia (low red blood cell count), and advanced chronic kidney disease who were not yet on dialysis.

Among this group, 14,117 patients (49.5 percent) were prescribed for an ACEI, an ARB, or both.

The researchers followed up with the patients for an average of seven months. During this time, 20,152 participants required dialysis and 5,696 participants died.

The authors of the study found that use of an ACEI and/or ARB was tied to a 6 percent decreased risk of requiring dialysis or dying.

The researchers estimated that use of ACEIs and ARBs could prevent 5.5 percent of advanced kidney disease patients from beginning long-term dialysis.

The benefit of the drugs was consistent across most subgroups of patients.

The researchers did note that the ACEI/ARB users were more likely to be hospitalized for hyperkalemia, or elevated levels of potassium in the blood. However, the hospitalizations did not significantly increase the risk of death among those patients.

The authors of the study concluded that ACEI/ARB therapy could provide some benefit to advanced kidney disease patients.

They added that physicians who prescribe ACEI/ARB therapy should be aware of and attempt to prevent hyperkalemia.

The study was published in JAMA Internal Medicine on December 16.

The research was supported by the National Science Council, the Taipei Veterans General Hospital, the National Health Research Institutes and the National Yang-Ming University. The researchers disclosed no conflicts of interest.

Review Date: 
December 20, 2013