Effectiveness and Tolerance of Renin-Angiotensin System Inhibitors With Aging in Chronic Kidney Disease
Renin-angiotensin system inhibitors (RASi) are recommended for slowing chronic kidney disease (CKD) progression to kidney failure. Their effectiveness and tolerance as patients age remain uncertain because older patients have often been excluded from clinical trials. CKD-REIN cohort study. We studie...
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| Veröffentlicht in: | Journal of the American Medical Directors Association 2022-06, Vol.23 (6), p.998-1004.e7 |
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| creator | Villain, Cédric Metzger, Marie Liabeuf, Sophie Hamroun, Aghilès Laville, Solene Mansencal, Nicolas Combe, Christian Fouque, Denis Frimat, Luc Jacquelinet, Christian Laville, Maurice Ayav, Carole Briançon, Serge Pecoits-Filho, Roberto Hannedouche, Thierry Stengel, Bénédicte Massy, Ziad A. Ayav, Carole Briançon, Serge Cannet, Dorothée Combe, Christian Fouque, Denis Frimat, Luc Herpe, Yves-Edouard Jacquelinet, Christian Laville, Maurice Massy, Ziad A. Pascal, Christophe Robinson, Bruce M. Stengel, Bénédicte Lange, Céline Legrand, Karine Liabeuf, Sophie Metzger, Marie Speyer, Elodie Hannedouche, Thierry Moulin, Bruno Mailliez, Sébastien Lebrun, Gaétan Magnant, Eric Choukroun, Gabriel Deroure, Benjamin Lacraz, Adeline Lambrey, Guy Bourdenx, Jean Philippe Essig, Marie Lobbedez, Thierry Azar, Raymond Sekhri, Hacène Smati, Mustafa Jamali, Mohamed Klein, Alexandre Delahousse, Michel Martin, Séverine Landru, Isabelle Thervet, Eric Lang, Philippe Belenfant, Xavier Urena, Pablo Vela, Carlos Chauveau, Dominique Panescu, Viktor Noel, Christian Glowacki, François Hoffmann, Maxime Hourmant, Maryvonne Besnier, Dominique Testa, Angelo Kuentz, François Zaoui, Philippe Chazot, Charles Juillard, Laurent Burtey, Stéphane Keller, Adrien Kamar, Nassim |
| description | Renin-angiotensin system inhibitors (RASi) are recommended for slowing chronic kidney disease (CKD) progression to kidney failure. Their effectiveness and tolerance as patients age remain uncertain because older patients have often been excluded from clinical trials.
CKD-REIN cohort study.
We studied 2762 patients with CKD stages 3 and 4 and a clinical indication for RASi enrolled between 2013 and 2016 in 40 nephrology clinics nationally representative in France.
The primary outcome was the occurrence of kidney failure or death. The secondary outcomes were the occurrence of cardiovascular events and hospitalizations with acute kidney injury (AKI) or hyperkalemia. A propensity score analysis was performed. We used Cox models to estimate hazard ratios (HRs) for each outcome associated with RASi prescription and tested interactions with age.
Patients' mean age was 67 years, including 841 (30%) aged 75 years and older; 2178 (79%) were prescribed RASi's. During a median follow-up of 4.6 years, 33% of patients reached kidney failure or died. RASi prescription was associated with a lower risk of kidney failure or death (HR 0.79, 95% CI 0.66, 0.95), an association not modified by age (P for interaction = .72). It was not significantly associated with cardiovascular events. During the first 3 years of follow-up, 14% of patients were hospitalized with AKI or hyperkalemia, but risk was not higher among those prescribed RASi's (HR 0.75, 95% CI 0.55-1.02) and age did not modify its effect (P for interaction = .28).
This study shows that aging does not appear to modify either RASi's beneficial effects on major CKD outcomes or their potential adverse effects. |
| doi_str_mv | 10.1016/j.jamda.2021.10.019 |
| format | Article |
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CKD-REIN cohort study.
We studied 2762 patients with CKD stages 3 and 4 and a clinical indication for RASi enrolled between 2013 and 2016 in 40 nephrology clinics nationally representative in France.
The primary outcome was the occurrence of kidney failure or death. The secondary outcomes were the occurrence of cardiovascular events and hospitalizations with acute kidney injury (AKI) or hyperkalemia. A propensity score analysis was performed. We used Cox models to estimate hazard ratios (HRs) for each outcome associated with RASi prescription and tested interactions with age.
Patients' mean age was 67 years, including 841 (30%) aged 75 years and older; 2178 (79%) were prescribed RASi's. During a median follow-up of 4.6 years, 33% of patients reached kidney failure or died. RASi prescription was associated with a lower risk of kidney failure or death (HR 0.79, 95% CI 0.66, 0.95), an association not modified by age (P for interaction = .72). It was not significantly associated with cardiovascular events. During the first 3 years of follow-up, 14% of patients were hospitalized with AKI or hyperkalemia, but risk was not higher among those prescribed RASi's (HR 0.75, 95% CI 0.55-1.02) and age did not modify its effect (P for interaction = .28).
This study shows that aging does not appear to modify either RASi's beneficial effects on major CKD outcomes or their potential adverse effects.</description><identifier>ISSN: 1525-8610</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2021.10.019</identifier><identifier>PMID: 34856172</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Kidney Injury - chemically induced ; Acute Kidney Injury - complications ; Acute Kidney Injury - drug therapy ; Aged ; Aging ; Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin-Converting Enzyme Inhibitors - adverse effects ; Antihypertensive Agents - therapeutic use ; Cardiovascular Diseases - drug therapy ; chronic kidney disease ; Cohort Studies ; Humans ; Hyperkalemia - chemically induced ; Hyperkalemia - complications ; Hyperkalemia - drug therapy ; Life Sciences ; propensity score analysis ; Renal Insufficiency, Chronic - drug therapy ; Renin-Angiotensin System ; Renin-angiotensin system inhibitors</subject><ispartof>Journal of the American Medical Directors Association, 2022-06, Vol.23 (6), p.998-1004.e7</ispartof><rights>2021 AMDA — The Society for Post-Acute and Long-Term Care Medicine</rights><rights>Copyright © 2021 AMDA — The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-1bdee644b7dc9830d33fff19c176f7d17caf0f8c93008081e856919d622d9cc23</citedby><cites>FETCH-LOGICAL-c441t-1bdee644b7dc9830d33fff19c176f7d17caf0f8c93008081e856919d622d9cc23</cites><orcidid>0000-0002-0214-5567 ; 0000-0003-0772-5656 ; 0000-0002-1490-7549 ; 0000-0001-5384-9006</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1525861021009397$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34856172$$D View this record in 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Philippe</creatorcontrib><creatorcontrib>Belenfant, Xavier</creatorcontrib><creatorcontrib>Urena, Pablo</creatorcontrib><creatorcontrib>Vela, Carlos</creatorcontrib><creatorcontrib>Chauveau, Dominique</creatorcontrib><creatorcontrib>Panescu, Viktor</creatorcontrib><creatorcontrib>Noel, Christian</creatorcontrib><creatorcontrib>Glowacki, François</creatorcontrib><creatorcontrib>Hoffmann, Maxime</creatorcontrib><creatorcontrib>Hourmant, Maryvonne</creatorcontrib><creatorcontrib>Besnier, Dominique</creatorcontrib><creatorcontrib>Testa, Angelo</creatorcontrib><creatorcontrib>Kuentz, François</creatorcontrib><creatorcontrib>Zaoui, Philippe</creatorcontrib><creatorcontrib>Chazot, Charles</creatorcontrib><creatorcontrib>Juillard, Laurent</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Keller, Adrien</creatorcontrib><creatorcontrib>Kamar, Nassim</creatorcontrib><creatorcontrib>CKD-REIN Study Group</creatorcontrib><title>Effectiveness and Tolerance of Renin-Angiotensin System Inhibitors With Aging in Chronic Kidney Disease</title><title>Journal of the American Medical Directors Association</title><addtitle>J Am Med Dir Assoc</addtitle><description>Renin-angiotensin system inhibitors (RASi) are recommended for slowing chronic kidney disease (CKD) progression to kidney failure. Their effectiveness and tolerance as patients age remain uncertain because older patients have often been excluded from clinical trials.
CKD-REIN cohort study.
We studied 2762 patients with CKD stages 3 and 4 and a clinical indication for RASi enrolled between 2013 and 2016 in 40 nephrology clinics nationally representative in France.
The primary outcome was the occurrence of kidney failure or death. The secondary outcomes were the occurrence of cardiovascular events and hospitalizations with acute kidney injury (AKI) or hyperkalemia. A propensity score analysis was performed. We used Cox models to estimate hazard ratios (HRs) for each outcome associated with RASi prescription and tested interactions with age.
Patients' mean age was 67 years, including 841 (30%) aged 75 years and older; 2178 (79%) were prescribed RASi's. During a median follow-up of 4.6 years, 33% of patients reached kidney failure or died. RASi prescription was associated with a lower risk of kidney failure or death (HR 0.79, 95% CI 0.66, 0.95), an association not modified by age (P for interaction = .72). It was not significantly associated with cardiovascular events. During the first 3 years of follow-up, 14% of patients were hospitalized with AKI or hyperkalemia, but risk was not higher among those prescribed RASi's (HR 0.75, 95% CI 0.55-1.02) and age did not modify its effect (P for interaction = .28).
This study shows that aging does not appear to modify either RASi's beneficial effects on major CKD outcomes or their potential adverse effects.</description><subject>Acute Kidney Injury - chemically induced</subject><subject>Acute Kidney Injury - complications</subject><subject>Acute Kidney Injury - drug therapy</subject><subject>Aged</subject><subject>Aging</subject><subject>Angiotensin Receptor Antagonists - therapeutic use</subject><subject>Angiotensin-Converting Enzyme Inhibitors - adverse effects</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Cardiovascular Diseases - drug therapy</subject><subject>chronic kidney disease</subject><subject>Cohort Studies</subject><subject>Humans</subject><subject>Hyperkalemia - chemically induced</subject><subject>Hyperkalemia - complications</subject><subject>Hyperkalemia - drug therapy</subject><subject>Life Sciences</subject><subject>propensity score analysis</subject><subject>Renal Insufficiency, Chronic - drug 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Serge ; Cannet, Dorothée ; Combe, Christian ; Fouque, Denis ; Frimat, Luc ; Herpe, Yves-Edouard ; Jacquelinet, Christian ; Laville, Maurice ; Massy, Ziad A. ; Pascal, Christophe ; Robinson, Bruce M. ; Stengel, Bénédicte ; Lange, Céline ; Legrand, Karine ; Liabeuf, Sophie ; Metzger, Marie ; Speyer, Elodie ; Hannedouche, Thierry ; Moulin, Bruno ; Mailliez, Sébastien ; Lebrun, Gaétan ; Magnant, Eric ; Choukroun, Gabriel ; Deroure, Benjamin ; Lacraz, Adeline ; Lambrey, Guy ; Bourdenx, Jean Philippe ; Essig, Marie ; Lobbedez, Thierry ; Azar, Raymond ; Sekhri, Hacène ; Smati, Mustafa ; Jamali, Mohamed ; Klein, Alexandre ; Delahousse, Michel ; Martin, Séverine ; Landru, Isabelle ; Thervet, Eric ; Lang, Philippe ; Belenfant, Xavier ; Urena, Pablo ; Vela, Carlos ; Chauveau, Dominique ; Panescu, Viktor ; Noel, Christian ; Glowacki, François ; Hoffmann, Maxime ; Hourmant, Maryvonne ; Besnier, Dominique ; Testa, Angelo ; Kuentz, François ; Zaoui, Philippe ; Chazot, Charles ; Juillard, Laurent ; Burtey, Stéphane ; Keller, Adrien ; Kamar, Nassim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-1bdee644b7dc9830d33fff19c176f7d17caf0f8c93008081e856919d622d9cc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acute Kidney Injury - chemically induced</topic><topic>Acute Kidney Injury - complications</topic><topic>Acute Kidney Injury - drug therapy</topic><topic>Aged</topic><topic>Aging</topic><topic>Angiotensin Receptor Antagonists - therapeutic use</topic><topic>Angiotensin-Converting Enzyme Inhibitors - adverse effects</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Cardiovascular Diseases - drug therapy</topic><topic>chronic kidney disease</topic><topic>Cohort Studies</topic><topic>Humans</topic><topic>Hyperkalemia - chemically induced</topic><topic>Hyperkalemia - complications</topic><topic>Hyperkalemia - drug therapy</topic><topic>Life Sciences</topic><topic>propensity score analysis</topic><topic>Renal Insufficiency, Chronic - drug therapy</topic><topic>Renin-Angiotensin System</topic><topic>Renin-angiotensin system inhibitors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Villain, Cédric</creatorcontrib><creatorcontrib>Metzger, Marie</creatorcontrib><creatorcontrib>Liabeuf, Sophie</creatorcontrib><creatorcontrib>Hamroun, Aghilès</creatorcontrib><creatorcontrib>Laville, Solene</creatorcontrib><creatorcontrib>Mansencal, Nicolas</creatorcontrib><creatorcontrib>Combe, Christian</creatorcontrib><creatorcontrib>Fouque, Denis</creatorcontrib><creatorcontrib>Frimat, Luc</creatorcontrib><creatorcontrib>Jacquelinet, Christian</creatorcontrib><creatorcontrib>Laville, Maurice</creatorcontrib><creatorcontrib>Ayav, Carole</creatorcontrib><creatorcontrib>Briançon, Serge</creatorcontrib><creatorcontrib>Pecoits-Filho, Roberto</creatorcontrib><creatorcontrib>Hannedouche, Thierry</creatorcontrib><creatorcontrib>Stengel, Bénédicte</creatorcontrib><creatorcontrib>Massy, Ziad A.</creatorcontrib><creatorcontrib>Ayav, Carole</creatorcontrib><creatorcontrib>Briançon, Serge</creatorcontrib><creatorcontrib>Cannet, Dorothée</creatorcontrib><creatorcontrib>Combe, Christian</creatorcontrib><creatorcontrib>Fouque, Denis</creatorcontrib><creatorcontrib>Frimat, Luc</creatorcontrib><creatorcontrib>Herpe, Yves-Edouard</creatorcontrib><creatorcontrib>Jacquelinet, Christian</creatorcontrib><creatorcontrib>Laville, Maurice</creatorcontrib><creatorcontrib>Massy, Ziad A.</creatorcontrib><creatorcontrib>Pascal, Christophe</creatorcontrib><creatorcontrib>Robinson, Bruce M.</creatorcontrib><creatorcontrib>Stengel, Bénédicte</creatorcontrib><creatorcontrib>Lange, Céline</creatorcontrib><creatorcontrib>Legrand, Karine</creatorcontrib><creatorcontrib>Liabeuf, Sophie</creatorcontrib><creatorcontrib>Metzger, Marie</creatorcontrib><creatorcontrib>Speyer, Elodie</creatorcontrib><creatorcontrib>Hannedouche, Thierry</creatorcontrib><creatorcontrib>Moulin, Bruno</creatorcontrib><creatorcontrib>Mailliez, Sébastien</creatorcontrib><creatorcontrib>Lebrun, Gaétan</creatorcontrib><creatorcontrib>Magnant, Eric</creatorcontrib><creatorcontrib>Choukroun, Gabriel</creatorcontrib><creatorcontrib>Deroure, Benjamin</creatorcontrib><creatorcontrib>Lacraz, Adeline</creatorcontrib><creatorcontrib>Lambrey, Guy</creatorcontrib><creatorcontrib>Bourdenx, Jean Philippe</creatorcontrib><creatorcontrib>Essig, Marie</creatorcontrib><creatorcontrib>Lobbedez, Thierry</creatorcontrib><creatorcontrib>Azar, Raymond</creatorcontrib><creatorcontrib>Sekhri, Hacène</creatorcontrib><creatorcontrib>Smati, Mustafa</creatorcontrib><creatorcontrib>Jamali, Mohamed</creatorcontrib><creatorcontrib>Klein, Alexandre</creatorcontrib><creatorcontrib>Delahousse, Michel</creatorcontrib><creatorcontrib>Martin, Séverine</creatorcontrib><creatorcontrib>Landru, Isabelle</creatorcontrib><creatorcontrib>Thervet, Eric</creatorcontrib><creatorcontrib>Lang, Philippe</creatorcontrib><creatorcontrib>Belenfant, Xavier</creatorcontrib><creatorcontrib>Urena, Pablo</creatorcontrib><creatorcontrib>Vela, Carlos</creatorcontrib><creatorcontrib>Chauveau, Dominique</creatorcontrib><creatorcontrib>Panescu, Viktor</creatorcontrib><creatorcontrib>Noel, Christian</creatorcontrib><creatorcontrib>Glowacki, François</creatorcontrib><creatorcontrib>Hoffmann, Maxime</creatorcontrib><creatorcontrib>Hourmant, Maryvonne</creatorcontrib><creatorcontrib>Besnier, Dominique</creatorcontrib><creatorcontrib>Testa, Angelo</creatorcontrib><creatorcontrib>Kuentz, François</creatorcontrib><creatorcontrib>Zaoui, Philippe</creatorcontrib><creatorcontrib>Chazot, Charles</creatorcontrib><creatorcontrib>Juillard, Laurent</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Keller, Adrien</creatorcontrib><creatorcontrib>Kamar, Nassim</creatorcontrib><creatorcontrib>CKD-REIN Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Journal of the American Medical Directors Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Villain, Cédric</au><au>Metzger, Marie</au><au>Liabeuf, Sophie</au><au>Hamroun, Aghilès</au><au>Laville, Solene</au><au>Mansencal, Nicolas</au><au>Combe, Christian</au><au>Fouque, Denis</au><au>Frimat, Luc</au><au>Jacquelinet, Christian</au><au>Laville, Maurice</au><au>Ayav, Carole</au><au>Briançon, Serge</au><au>Pecoits-Filho, Roberto</au><au>Hannedouche, Thierry</au><au>Stengel, Bénédicte</au><au>Massy, Ziad A.</au><au>Ayav, Carole</au><au>Briançon, Serge</au><au>Cannet, Dorothée</au><au>Combe, Christian</au><au>Fouque, Denis</au><au>Frimat, Luc</au><au>Herpe, Yves-Edouard</au><au>Jacquelinet, Christian</au><au>Laville, Maurice</au><au>Massy, Ziad A.</au><au>Pascal, Christophe</au><au>Robinson, Bruce M.</au><au>Stengel, Bénédicte</au><au>Lange, Céline</au><au>Legrand, Karine</au><au>Liabeuf, Sophie</au><au>Metzger, Marie</au><au>Speyer, Elodie</au><au>Hannedouche, Thierry</au><au>Moulin, Bruno</au><au>Mailliez, Sébastien</au><au>Lebrun, Gaétan</au><au>Magnant, Eric</au><au>Choukroun, Gabriel</au><au>Deroure, Benjamin</au><au>Lacraz, Adeline</au><au>Lambrey, Guy</au><au>Bourdenx, Jean Philippe</au><au>Essig, Marie</au><au>Lobbedez, Thierry</au><au>Azar, Raymond</au><au>Sekhri, Hacène</au><au>Smati, Mustafa</au><au>Jamali, Mohamed</au><au>Klein, Alexandre</au><au>Delahousse, Michel</au><au>Martin, Séverine</au><au>Landru, Isabelle</au><au>Thervet, Eric</au><au>Lang, Philippe</au><au>Belenfant, Xavier</au><au>Urena, Pablo</au><au>Vela, Carlos</au><au>Chauveau, Dominique</au><au>Panescu, Viktor</au><au>Noel, Christian</au><au>Glowacki, François</au><au>Hoffmann, Maxime</au><au>Hourmant, Maryvonne</au><au>Besnier, Dominique</au><au>Testa, Angelo</au><au>Kuentz, François</au><au>Zaoui, Philippe</au><au>Chazot, Charles</au><au>Juillard, Laurent</au><au>Burtey, Stéphane</au><au>Keller, Adrien</au><au>Kamar, Nassim</au><aucorp>CKD-REIN Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness and Tolerance of Renin-Angiotensin System Inhibitors With Aging in Chronic Kidney Disease</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><addtitle>J Am Med Dir Assoc</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>23</volume><issue>6</issue><spage>998</spage><epage>1004.e7</epage><pages>998-1004.e7</pages><issn>1525-8610</issn><eissn>1538-9375</eissn><abstract>Renin-angiotensin system inhibitors (RASi) are recommended for slowing chronic kidney disease (CKD) progression to kidney failure. Their effectiveness and tolerance as patients age remain uncertain because older patients have often been excluded from clinical trials.
CKD-REIN cohort study.
We studied 2762 patients with CKD stages 3 and 4 and a clinical indication for RASi enrolled between 2013 and 2016 in 40 nephrology clinics nationally representative in France.
The primary outcome was the occurrence of kidney failure or death. The secondary outcomes were the occurrence of cardiovascular events and hospitalizations with acute kidney injury (AKI) or hyperkalemia. A propensity score analysis was performed. We used Cox models to estimate hazard ratios (HRs) for each outcome associated with RASi prescription and tested interactions with age.
Patients' mean age was 67 years, including 841 (30%) aged 75 years and older; 2178 (79%) were prescribed RASi's. During a median follow-up of 4.6 years, 33% of patients reached kidney failure or died. RASi prescription was associated with a lower risk of kidney failure or death (HR 0.79, 95% CI 0.66, 0.95), an association not modified by age (P for interaction = .72). It was not significantly associated with cardiovascular events. During the first 3 years of follow-up, 14% of patients were hospitalized with AKI or hyperkalemia, but risk was not higher among those prescribed RASi's (HR 0.75, 95% CI 0.55-1.02) and age did not modify its effect (P for interaction = .28).
This study shows that aging does not appear to modify either RASi's beneficial effects on major CKD outcomes or their potential adverse effects.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34856172</pmid><doi>10.1016/j.jamda.2021.10.019</doi><tpages>-931</tpages><orcidid>https://orcid.org/0000-0002-0214-5567</orcidid><orcidid>https://orcid.org/0000-0003-0772-5656</orcidid><orcidid>https://orcid.org/0000-0002-1490-7549</orcidid><orcidid>https://orcid.org/0000-0001-5384-9006</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1525-8610 |
| ispartof | Journal of the American Medical Directors Association, 2022-06, Vol.23 (6), p.998-1004.e7 |
| issn | 1525-8610 1538-9375 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_inserm_03587209v1 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute Kidney Injury - chemically induced Acute Kidney Injury - complications Acute Kidney Injury - drug therapy Aged Aging Angiotensin Receptor Antagonists - therapeutic use Angiotensin-Converting Enzyme Inhibitors - adverse effects Antihypertensive Agents - therapeutic use Cardiovascular Diseases - drug therapy chronic kidney disease Cohort Studies Humans Hyperkalemia - chemically induced Hyperkalemia - complications Hyperkalemia - drug therapy Life Sciences propensity score analysis Renal Insufficiency, Chronic - drug therapy Renin-Angiotensin System Renin-angiotensin system inhibitors |
| title | Effectiveness and Tolerance of Renin-Angiotensin System Inhibitors With Aging in Chronic Kidney Disease |
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