Mortality benefit of angiotensin-converting enzyme inhibitors after cardiac events in patients with end-stage renal disease

McCullough, Peter A.; Sandberg, Keisha R.; Yee, Jerry; Hudson, Michael

doi:10.3317/jraas.2002.040

Cited by 58 publications

(33 citation statements)

References 17 publications

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“…27,28 For example, azotemia and hyperkalemia restrict the use of drugs that antagonize therenin-angiotensin system. 29,30 CKD also worsens the presentation, severity,response to treatment and cardiorenal outcomes in acuteand chronic hypertension. 31,32 Adapted from: McCullough PA.Cardiorenal syndromes.…”

Section: Chronic Renocardiac Syndrome (Crs Type 4)mentioning

confidence: 99%

Cardiorenal Syndrome - A Review Article

Neki

2015

J. Medicine

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Cardiorenal syndromes (CRS) describe the dynamic inter-relationship between heart and kidney malfunction. Recent studies have clearly defined its various types and pathophysiology. Improved survival, cardiovascular risk factors (diabetes, hypertension, dyslipidemia), diagnostic and therapeutic intervention are some contributors in its causation. Types 1 and 2 CRS involve acute and chronic cardiovascular disease (CVD) scenarios leading to acute kidney injury or accelerated chronic kidney disease. Types 3 and 4 CRS describe acute and chronic kidney disease leading primarily to heart failure, although it is possible that acute coronary syndromes, stroke, and arrhythmias could be CVD outcomes in these forms of CRS. Finally, CRS type 5 describes a simultaneous insult to both heart and kidneys, such as sepsis, where both organs are injured simultaneously. This article focuses on different types, pathophysiology, novel biomarkers, preventive and treatment aspects of cardiorenal syndromes.DOI: http://dx.doi.org/10.3329/jom.v16i1.22400 J MEDICINE 2015; 16 : 39-45

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Section: Chronic Renocardiac Syndrome (Crs Type 4)mentioning

confidence: 99%

Cardiorenal Syndrome - A Review Article

Neki

2015

J. Medicine

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“…Observational studies of patients who present with acute coronary syndromes indicate reduced rates of death over 5 yr in patients who received ASA, BB, and ACEI (17,18). They are less frequently used in patients with ESRD because of increase rates of bleeding with aspirin, bradycardia and conduction system disease with BB, and hyperkalemia with ACEI.…”

Section: Esrd: More Than a Coronary Heart Risk Equivalentmentioning

confidence: 99%

Coronary Artery Disease

McCullough

2007

Clinical Journal of the American Society of Nephrology

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Coronary heart disease is the most common cause of death in the general population and in patients with ESRD. The principles of cardiovascular risk assessment and management apply to both populations. Advances in noninvasive coronary artery imaging have improved early detection of subclinical disease. The goals of medical management of coronary disease are to modify the natural history of disease and to improve the symptoms of angina. Coronary revascularization poses a different risk and benefit equation in the ESRD population. In stable ESRD with multivessel coronary artery disease, coronary bypass surgery, despite the upfront risks of stroke, myocardial infarction, and chest wound infection, seems to be a favored approach. In patients with ESRD and acute coronary syndromes, percutaneous coronary intervention on the target vessel has been associated with the most favorable outcomes. This article explores the clinical issues with respect to coronary artery disease in patients with ESRD.Clin J Am Soc Nephrol 2: 611-616, 2007611-616, . doi: 10.2215 C oronary heart disease is the leading cause of death in the US general population. With the obesity pandemic and the expected worsening of cardiovascular risk factors in the general population, the incidence and the prevalence of heart disease is expected to rise. Coronary artery disease (CAD) is the leading cause of death in patients with chronic kidney disease (CKD): Of the more than 320,000 patients with ESRD that requires dialysis or kidney transplantation in the United States, half will die from cardiovascular causes, and patients with milder degrees of CKD are more likely to die of CAD than to develop kidney failure that requires renal replacement therapy (1).The observational studies concerning CAD and ESRD have revealed the following: (1) By the time patients reach dialysis, approximately 70% have significant coronary artery calcification indicative of coronary atherosclerosis, (2) patients with CAD and ESRD have markedly increased mortality over the general population, (3) treatment with disease-modifying therapy that is proved to reduce rates of (MI) or death (e.g., aspirin, ␤ adrenergic receptor blockers [BB], angiotensin-converting enzyme inhibitors [ACEI], 3-methylglutaryl CoA reductase inhibitors or statins) are used less frequently in patients with ESRD than in the general population, (4) noninvasive imaging seems to have less precision and accuracy in patients with ESRD, and (5) patients who have ESRD and are selected for revascularization with coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) have improved survival compared with those who are treated with medical therapy alone (2-6). Table 1 presents a summary of CAD risk reduction, diagnosis, and management principles. Recommendations in Table 1 present a task list for optimal (not minimal) clinical goals and go beyond many current professional society guidelines concerning the individual treatment targets. ESRD: More Than a Coronary Heart Risk EquivalentPatients with ES...

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“…To date, no long-term outcome studies have been conducted in this population with either of these drug classes, although these drugs are in common use when CHF exists. 50,51 Although ACE-Is can be presumed to be 'effective' when CHF is present in the ESRD patient, this is by inference alone from studies conducted in non-ESRD CHF populations. It is probable that the alteration in Ang II effect, from either ACE-I or ARB therapy, would offer some therapeutic benefit to the ESRD patient with CHF.…”

Section: Pharmacodynamicsmentioning

confidence: 99%

Review: The pharmacokinetics and pharmacodynamics of angiotensin-receptor blockers in end-stage renal disease

Sica¹,

Gehr

2002

J Renin Angiotensin Aldosterone Syst

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Angiotensin-converting enzyme (ACE) inhibitors and more recently angiotensin-receptor blockers (ARBs) have become popular therapies in the end-stage renal disease (ESRD) patient. The ability of either of these drug classes to reduce blood pressure in the ESRD patient is well accepted; however, there is considerably less information available to guide the clinician in the safe and effective use of these drugs in the ESRD patient with congestive heart failure and/or coronary artery disease. Head-to-head studies in the ESRD patient are lacking for both drug classes. Several pharmacokinetic factors can influence the selection of these drugs, including dialysability and the propensity for systemic accumulation. ACE inhibitors (ACE-Is) and ARBs are recognised as having a range of nonpressor effects that are pertinent to patients with ESRD. Such effects include their ability to decrease both thirst drive and erythropoiesis. These drug classes, though, are distinguishable by the unique adverse effect profile for ACE-Is. As is the case in patients without renal failure, ESRD patients can experience cough and, less frequently, angioneurotic oedema with ACE-Is. In the ESRD population, so-called anaphylactoid dialyser reactions can occur in conjunction with ACE-I use. The use of a drug from within the ARB class carries both less risk and permits a compound with a preferred pharmacokinetic profile -limited dialysability and minimal systemic accumulation -to be administered. These attributes would favour the increased use of ARBs in this population.

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Mortality benefit of angiotensin-converting enzyme inhibitors after cardiac events in patients with end-stage renal disease

Cited by 58 publications

References 17 publications

Cardiorenal Syndrome - A Review Article

Cardiorenal Syndrome - A Review Article

Coronary Artery Disease

Review: The pharmacokinetics and pharmacodynamics of angiotensin-receptor blockers in end-stage renal disease

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