Effects of the Renin-Angiotensin system blockade on hemoglobin levels in type 2 diabetic patients with chronic kidney disease

American Journal of Hypertension
Aiko InoueYasuhiko Iwamoto

Abstract

Treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) may be associated with reduced erythrocyte production in several clinical settings; however, these effects have not been determined in diabetic patients with chronic kidney disease (CKD), a high-risk population for anemia. We conducted a retrospective study to assess the effects of ACEIs and ARBs on hemoglobin levels in Japanese adults with type 2 diabetes and CKD. Diabetic patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2), who filled a prescription for an ACEI or ARB, were included. Changes in hemoglobin levels after initiating treatment with an ACEI or ARB were compared using multivariate analysis of covariance (ANCOVA) and propensity-score matching to minimize the bias. A total of 201 diabetic patients, 77 treated with an ACEI and 124 treated with an ARB, fulfilled study criteria and constituted the retrospective cohort. Mean (+/-s.e.) change in hemoglobin (adjusted for covariates) was greater for patients treated with ARBs (-0.43 +/- 0.08 g/dl) than patients treated with ACEIs (-0.11 +/- 0.11 g/dl, P = 0.025) by ANCOVA. In the propensity-score cohort analysis of 57 pairs of ACEI/ARB-treate...Continue Reading

References

Oct 1, 1992·British Journal of Clinical Pharmacology·M C PrattJ Livesey
Oct 1, 1990·Scandinavian Journal of Clinical and Laboratory Investigation·A L Kamper, O J Nielsen
Feb 1, 1989·Proceedings of the National Academy of Sciences of the United States of America·M LenfantE Frindel
Feb 12, 1998·Annals of Internal Medicine·D B Rubin
Dec 31, 1997·The Journal of Clinical Investigation·M MrugJ T Prchal
Aug 5, 1998·Lancet·A SchwarzbeckU Hällfritzsch
Aug 24, 1999·American Journal of Epidemiology·M M Joffe, P R Rosenbaum
Aug 26, 1999·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·I C Macdougall
Oct 3, 1999·Kidney International·A SahaiR L Tannen
Sep 22, 2001·The New England Journal of Medicine·B M BrennerUNKNOWN RENAAL Study Investigators
Mar 1, 2002·Diabetic Medicine : a Journal of the British Diabetic Association·D R BosmanP J Watkins
Mar 29, 2003·Diabetes Care·Merlin C ThomasGeorge Jerums
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Apr 22, 2004·Journal of the American Society of Nephrology : JASN·Wolfgang C WinkelmayerAnil Chandraker
Aug 26, 2004·Kidney International·Anupama MohanramRobert D Toto
Aug 26, 2004·Kidney International·Merlin C ThomasGeorge Jerums
Nov 2, 2004·The New England Journal of Medicine·Piero RuggenentiUNKNOWN Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) Investigators
Aug 22, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Aiko InoueYasuhiko Iwamoto
Dec 29, 2006·Diabetes Care·UNKNOWN American Diabetes Association
Jan 11, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jérôme RossertWilliam McClellan
Mar 29, 2007·Diabetes Care·Hirofumi MakinoUNKNOWN INNOVATION Study Group

❮ Previous
Next ❯

Citations

Feb 24, 2015·QJM : Monthly Journal of the Association of Physicians·W CheungpasitpornS B Erickson
Oct 31, 2013·Diabetes/metabolism Research and Reviews·Chagai GrossmanAvshalom Leibowitz
Aug 9, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Rupal MehtaUNKNOWN CRIC Study Investigators
Jun 13, 2019·The New England Journal of Medicine·Baris AfsarMehmet Kanbay
Sep 7, 2019·Journal of Hypertension·Demetrios V VlahakosGiuseppe Mancia
Jun 13, 2020·British Journal of Clinical Pharmacology·George H B GreenhallLaurie A Tomlinson
May 29, 2015·International Urology and Nephrology·M PappaK Katopodis
Jun 13, 2019·The New England Journal of Medicine·Iain C Macdougall, Ian Ford

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.