What question did this study set out to answer?

To evaluate the risks associated with discontinuing RAS inhibitors in patients with advanced chronic kidney disease (CKD).

March 28, 2026Open Access

Wcn26-8420 Severe Renal Osteodystrophy and Hungry Bone Syndrome

Key Points

To evaluate the risks associated with discontinuing RAS inhibitors in patients with advanced chronic kidney disease (CKD).
Analyzed data from 1,434 patients with a follow-up of 35 months
Compared outcomes in patients who discontinued RAS inhibitors versus those who continued
Assessed risks of major adverse cardiovascular events (MACE) and kidney replacement therapy (KRT) initiation.
27% of patients discontinued RAS inhibitors during the study
Risk of MACE was 2.02 times higher with discontinuation
KRT initiation risk increased by 1.34 times following RAS inhibitor discontinuation.

Abstract

Results: Among the 1,434 patients included (median age 68 years, median eGFR 25mL/min/1.73m2,35% women), 386 (27%) discontinued RAS inhibitors over a median follow-up of 35 months.The 3-year adjusted relative risk of MACE associated to discontinuing RAS inhibitors, compared to continuing, was 2.02 (95% CI, 1.62 to 2.47), and that of KRT initiation, 1.34 (95% CI, 1.14 to 1.60). Conclusion:RAS inhibitor discontinuation was strongly associated with MACE and KRT risks, the leading causes of morbidity and mortality in advanced CKD.Our results, along with other published data, suggest that the risk-benefit balance favors continued use of RAS inhibitors in this population.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.

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Cite This Study

Muthukumaran et al. (Wed,) studied this question.

synapsesocial.com/papers/69c770418bbfbc51511e06ec https://doi.org/https://doi.org/10.1016/j.ekir.2026.104276

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