Original Investigations: Dialysis TherapiesACE inhibitors and survival of hemodialysis patients*,**
Section snippets
Methods
Clinical data and details of medical treatment were extracted from charts of 177 patients on hemodialysis therapy between January 1994 and December 2000 at our medical center. Patients were excluded if they were on dialysis therapy for less than 1 year before data collection, had undergone kidney transplantation, left the hemodialysis unit, had a mean Kt/V less than 1 during the follow-up period, or clinical information was inadequate. Kt/V was calculated using a single-pool model by the
Results
Of 177 patients with ESRD who started hemodialysis therapy between 1994 and 1999, a total of 23 patients underwent kidney transplantation, 9 patients left the unit, and 15 patients had a mean Kt/V less than 1 because of vascular problems. In the records of 4 patients, clinical data were inadequate. The study population therefore included 126 chronic hemodialysis patients. Mean follow-up was 59 months (range, 8 to 113 months).
At the start of dialysis therapy, 66 patients (52%) were administered
Discussion
ACE inhibitors can limit the detrimental effect of angiotensin II on the cardiovascular system and kidneys, ameliorating functional and structural changes produced by progressive renal insufficiency. Clinical trials in patients both with and without diabetes indicate a favorable effect of ACE inhibitors in delaying the progression of renal disease.22 Moreover, the Heart Outcome Prevention Evaluation study showed a decrease in mortality associated with treatment with the ACE inhibitor ramipril
Acknowledgements
The authors thank Pearl Lilos, BSc, from the Laboratory of Statistics, Department of Mathematics, Tel-Aviv University, for assistance with statistical analysis.
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Address reprint requests to Shai Efrati, MD, Department of Internal Medicine A, Assaf Harofeh Medical Center, Zerifin 70300, Israel. E-mail: [email protected]
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