Angiotensin receptor blockers are associated with lower mortality than ACE inhibitors in predialytic stage 5 chronic kidney disease: A nationwide study of therapy with renin-angiotensin system blockade

Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit

据报道，采用血管紧张素受体拮抗剂（angiotensin-receptor blockers, ARBs）联合血管紧张素转换酶抑制剂（angiotensin converting enzyme inhibitors, ACEIs）的双重肾素-血管紧张素系统（renin angiotensin system, RAS）阻断疗法，可改善糖尿病与非糖尿病患者的蛋白尿症状。然而，该疗法针对晚期慢性肾脏病（chronic kidney disease, CKD）患者的肾脏保护作用与安全性仍不明确。本研究于2000年1月1日至2009年6月30日期间，纳入了14117例血清肌酐＞6mg/dL的透析前5期慢性肾脏病患者，且血细胞比容