Some patients who are required to begin hemodialysis may already have advanced cardiovascular disease that is not helped by an angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB).
Tedine P. Ranich, MD, and colleagues, from George Washington University, Washington, DC, and Gambro Healthcare, Fort Lauderdale, Florida, United States, assessed the relationship between ACE inhibitor and/or ARB use in chronic hemodialysis patients, and presented the results here at the 35th Annual Meeting of the American Society of Nephrology.
A total of 19,609 hemodialysis patients were studied for the relationship of race, age, gender, cause of end-stage renal disease, private versus government health insurance, cardiovascular medications, blood pressure, albumin, dialysis clearance, phosphorus and parathyroid hormone to mortality.
The investigators found that only 5 percent of the prevalent patients were treated with either an ACE inhibitor or ARB, and the majority of hemodialysis patients were not receiving a cardiovascular medication. Untreated patients had lower mortality, possibly reflecting the absence of cardiovascular disease
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