Why the study?
Does stopping RAS inhibition affect the risk of mortality, major adverse cardiovascular events, and initiation of kidney replacement therapy in people with advanced CKD?
Does stopping RAS inhibition affect the risk of mortality, major adverse cardiovascular events, and initiation of kidney replacement therapy in people with advanced CKD?
In patients with advanced CKD, stopping RAS inhibitors may increase the risk of mortality and cardiovascular events while decreasing the risk of needing kidney replacement therapy.
Should not yet change RAS inhibitor practice in advanced CKD; leaves open need for RCTs to confirm mortality-KRT trade-offs.
In this nationwide observational study of people with advanced CKD, stopping RAS inhibition was associated with higher absolute risks of mortality and major adverse cardiovascular events, but also with a lower absolute risk of initiating KRT.
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Fu et al. (2020) studied this question.
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