Journal of the Renin-Angiotensin-Aldosterone System (2015-12-01)

Possible prevention of dialysis-requiring congestive heart failure by angiotensin-II receptor blockers in non-dialysis Japanese patients with Stage 5 chronic kidney disease

  • Masato Ikeda,
  • Masatsugu Nakao,
  • Keita Hirano,
  • Keitaro Yokoyama,
  • Takashi Yokoo,
  • Nobuhiko Joki,
  • Ryoichi Ando,
  • Toshio Shinoda,
  • Daijo Inaguma,
  • Toshihiko Yamaka,
  • Yasuhiro Komatsu,
  • Fumihiko Koiwa,
  • Toshifumi Sakaguchi,
  • Shigeo Negi,
  • Takashi Shigematsu

DOI
https://doi.org/10.1177/1470320315592565
Journal volume & issue
Vol. 16

Abstract

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Background: Preventive medications for dialysis-requiring congestive heart failure (CHF) in non-dialysis Japanese patients with Stage 5 chronic kidney disease (CKD) are unknown. Our aim was to explore which CKD medication was associated with a reduced prevalence of dialysis-requiring CHF in non-dialysis Japanese patients with Stage 5 CKD. Methods: The present multicenter, retrospective, cross-sectional study examined the association between CKD medications and the prevalence of dialysis-requiring CHF in non-dialysis Japanese patients with Stage 5 CKD. Results: There were 1536 Japanese Stage 5 CKD patients who satisfied our inclusion criteria. We had 309 (20.1%) patients whom had developed dialysis-requiring CHF and 940 patients (60.8%) whom had been using angiotensin-II receptor blockers (ARBs) before initiating dialysis. In our multivariate analysis, only ARB use was significantly associated with a lower risk of CHF (Odds ratio (OR): 0.680, 95% confidence interval (CI): 0.516–0.897; p = 0.0064), of the CKD treatments examined in this study. Conclusions: We found that ARB use during the pre-dialysis period is associated with a lower prevalence of CHF in the non-dialysis Japanese patients with Stage 5 CKD, suggesting a possible prevention of dialysis-requiring CHF by ARBs, in non-dialysis Japanese patients with Stage 5 CKD.