Masato Ikeda1, Masatsugu Nakao2, Keita Hirano3, Keitaro Yokoyama4, Takashi Yokoo4, Nobuhiko Joki5, Ryoichi Ando6, Toshio Shinoda7, Daijo Inaguma8, Toshihiko Yamaka9, Yasuhiro Komatsu10, Fumihiko Koiwa11, Toshifumi Sakaguchi12, Shigeo Negi12, Takashi Shigematsu12. 1. Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Katsushika medical center, Tokyo, Japan aoto-jinnai@jikei.ac.jp. 2. Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Katsushika medical center, Tokyo, Japan. 3. Department of Nephrology, Asikaga Red Cross Hospital, Gunma, Japan. 4. Division of Nephrology and Hypertension, Jikei University School of Medicine, Tokyo, Japan. 5. Division of Nephrology, Toho University, Ohashi Medical Center, Tokyo, Japan. 6. Department of Nephrology, Musashino Red Cross Hospital, Tokyo, Japan. 7. Dialysis Center, Kawakita General Hospital, Tokyo, Japan. 8. Kidney Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan. 9. Department of Clinical Engineering, Tokyo Yamate Medical Center, Tokyo, Japan. 10. Department of Nephrology, Division of Internal Medicine, Saint Luke's International Hospital, Tokyo, Japan. 11. Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan. 12. Division of Nephrology, Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
Abstract
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.
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.