ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients
Background Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknow...
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| Veröffentlicht in: | Clinical and experimental nephrology 2022-03, Vol.26 (3), p.278-285 |
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| creator | Xie, Yuxin Zhu, Liya Wang, Zebin Zhan, Xiaojiang Peng, Fenfen Feng, Xiaoran Zhou, Qian Wu, Xianfeng Wang, Xiaoyang Su, Ning Tang, Xingming Zhang, Yujing Zeng, Yingsi Li, Mengmeng Liang, Jianbo Liu, Lingling Wen, Yueqiang |
| description | Background
Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknown.
Methods
Overall, 734 PD patients were enrolled after using propensity score matching. Kaplan–Meier analysis and COX regression were used to explore correlation between ACEi/ARBs and GIB. Competitive risk model was aimed to identify whether other events were confounding factors. Forest plot was applied to assess the influence of ACEI/ARBs on GIB incidence in different groups.
Results
During 8-year follow-up, 89 (12.13%) cases of GIB were recorded. Kaplan–Meier analysis revealed that the incidence of GIB among patients taking ACEi/ARBs was lower than those subjects who had not (log rank = 6.442,
P
= 0.011). After adjusted different confounding factors, administration of ACEi/ARBs was associated with lowered GIB incidence (adjusted HR = 0.49, 95% CI 0.32–0.77,
P
= 0.002). In competitive risk model, considering of other events, the incidence of GIB in two groups was still statistically significant (
P
= 0.010). Subgroup analysis showed ACEi/ARBs taking impeded GIB in the ≥ 60 age group (HR = 0.52, 95% CI 0.28–0.98,
P
= 0.040).
Conclusion
PD patients who were submitted to ACEi/ARBs inclined to have a lower risk for GIB. In this regard, ACEi/ARBs offered a promising choice to GIB. |
| doi_str_mv | 10.1007/s10157-021-02150-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2586450276</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2586450276</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-5c73f9ad4a897bf291ca7c77df054e9e247a128258f70b4c7188baa7542b75be3</originalsourceid><addsrcrecordid>eNp9kU-PFCEQxYnRuH_0C3gwJF68tAs0TDXHcbK6JpuYGD0Tmq4e2fTASDHZ7LeXcVZNPHggEOr3XlE8xl5J8U4KAVckhTTQCSWPy4hOP2HnUvfQAVj7tJ17rToJRp6xC6I7IcRgjX3Oznq9soOV5pzhenMdr9Zf3hP3RDlEX5Hfx_qdL_keC48pxAlTQJ5nvvVUS46pItWY_MLHBXGKadswvscSa07YrqfolweKxPe-RkyVXrBns18IXz7ul-zbh-uvm5vu9vPHT5v1bRe0MLUzAfrZ-kn7wcI4KyuDhwAwzcJotKg0eKkGZYYZxKgDyGEYvQej1QhmxP6SvT357kv-cWivdLtIAZfFJ8wHck250kYoWDX0zT_oXT6UNlSjVmqwQglxpNSJCiUTFZzdvsSdLw9OCncMwZ1CcC0A9ysEp5vo9aP1Ydzh9Efy-9cb0J8AaqW0xfK3939sfwI0GJJG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2628902006</pqid></control><display><type>article</type><title>ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients</title><source>Springer Nature - Complete Springer Journals</source><creator>Xie, Yuxin ; Zhu, Liya ; Wang, Zebin ; Zhan, Xiaojiang ; Peng, Fenfen ; Feng, Xiaoran ; Zhou, Qian ; Wu, Xianfeng ; Wang, Xiaoyang ; Su, Ning ; Tang, Xingming ; Zhang, Yujing ; Zeng, Yingsi ; Li, Mengmeng ; Liang, Jianbo ; Liu, Lingling ; Wen, Yueqiang</creator><creatorcontrib>Xie, Yuxin ; Zhu, Liya ; Wang, Zebin ; Zhan, Xiaojiang ; Peng, Fenfen ; Feng, Xiaoran ; Zhou, Qian ; Wu, Xianfeng ; Wang, Xiaoyang ; Su, Ning ; Tang, Xingming ; Zhang, Yujing ; Zeng, Yingsi ; Li, Mengmeng ; Liang, Jianbo ; Liu, Lingling ; Wen, Yueqiang</creatorcontrib><description>Background
Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknown.
Methods
Overall, 734 PD patients were enrolled after using propensity score matching. Kaplan–Meier analysis and COX regression were used to explore correlation between ACEi/ARBs and GIB. Competitive risk model was aimed to identify whether other events were confounding factors. Forest plot was applied to assess the influence of ACEI/ARBs on GIB incidence in different groups.
Results
During 8-year follow-up, 89 (12.13%) cases of GIB were recorded. Kaplan–Meier analysis revealed that the incidence of GIB among patients taking ACEi/ARBs was lower than those subjects who had not (log rank = 6.442,
P
= 0.011). After adjusted different confounding factors, administration of ACEi/ARBs was associated with lowered GIB incidence (adjusted HR = 0.49, 95% CI 0.32–0.77,
P
= 0.002). In competitive risk model, considering of other events, the incidence of GIB in two groups was still statistically significant (
P
= 0.010). Subgroup analysis showed ACEi/ARBs taking impeded GIB in the ≥ 60 age group (HR = 0.52, 95% CI 0.28–0.98,
P
= 0.040).
Conclusion
PD patients who were submitted to ACEi/ARBs inclined to have a lower risk for GIB. In this regard, ACEi/ARBs offered a promising choice to GIB.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-021-02150-4</identifier><identifier>PMID: 34698915</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Angiotensin ; Angiotensin II ; Angiotensin-converting enzyme inhibitors ; Bleeding ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Peptidyl-dipeptidase A ; Peritoneal dialysis ; Peritoneum ; Renal function ; Statistical analysis ; Urology</subject><ispartof>Clinical and experimental nephrology, 2022-03, Vol.26 (3), p.278-285</ispartof><rights>Japanese Society of Nephrology 2021</rights><rights>2021. Japanese Society of Nephrology.</rights><rights>Japanese Society of Nephrology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c405t-5c73f9ad4a897bf291ca7c77df054e9e247a128258f70b4c7188baa7542b75be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10157-021-02150-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10157-021-02150-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34698915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xie, Yuxin</creatorcontrib><creatorcontrib>Zhu, Liya</creatorcontrib><creatorcontrib>Wang, Zebin</creatorcontrib><creatorcontrib>Zhan, Xiaojiang</creatorcontrib><creatorcontrib>Peng, Fenfen</creatorcontrib><creatorcontrib>Feng, Xiaoran</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Wu, Xianfeng</creatorcontrib><creatorcontrib>Wang, Xiaoyang</creatorcontrib><creatorcontrib>Su, Ning</creatorcontrib><creatorcontrib>Tang, Xingming</creatorcontrib><creatorcontrib>Zhang, Yujing</creatorcontrib><creatorcontrib>Zeng, Yingsi</creatorcontrib><creatorcontrib>Li, Mengmeng</creatorcontrib><creatorcontrib>Liang, Jianbo</creatorcontrib><creatorcontrib>Liu, Lingling</creatorcontrib><creatorcontrib>Wen, Yueqiang</creatorcontrib><title>ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknown.
Methods
Overall, 734 PD patients were enrolled after using propensity score matching. Kaplan–Meier analysis and COX regression were used to explore correlation between ACEi/ARBs and GIB. Competitive risk model was aimed to identify whether other events were confounding factors. Forest plot was applied to assess the influence of ACEI/ARBs on GIB incidence in different groups.
Results
During 8-year follow-up, 89 (12.13%) cases of GIB were recorded. Kaplan–Meier analysis revealed that the incidence of GIB among patients taking ACEi/ARBs was lower than those subjects who had not (log rank = 6.442,
P
= 0.011). After adjusted different confounding factors, administration of ACEi/ARBs was associated with lowered GIB incidence (adjusted HR = 0.49, 95% CI 0.32–0.77,
P
= 0.002). In competitive risk model, considering of other events, the incidence of GIB in two groups was still statistically significant (
P
= 0.010). Subgroup analysis showed ACEi/ARBs taking impeded GIB in the ≥ 60 age group (HR = 0.52, 95% CI 0.28–0.98,
P
= 0.040).
Conclusion
PD patients who were submitted to ACEi/ARBs inclined to have a lower risk for GIB. In this regard, ACEi/ARBs offered a promising choice to GIB.</description><subject>Angiotensin</subject><subject>Angiotensin II</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Bleeding</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Peptidyl-dipeptidase A</subject><subject>Peritoneal dialysis</subject><subject>Peritoneum</subject><subject>Renal function</subject><subject>Statistical analysis</subject><subject>Urology</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU-PFCEQxYnRuH_0C3gwJF68tAs0TDXHcbK6JpuYGD0Tmq4e2fTASDHZ7LeXcVZNPHggEOr3XlE8xl5J8U4KAVckhTTQCSWPy4hOP2HnUvfQAVj7tJ17rToJRp6xC6I7IcRgjX3Oznq9soOV5pzhenMdr9Zf3hP3RDlEX5Hfx_qdL_keC48pxAlTQJ5nvvVUS46pItWY_MLHBXGKadswvscSa07YrqfolweKxPe-RkyVXrBns18IXz7ul-zbh-uvm5vu9vPHT5v1bRe0MLUzAfrZ-kn7wcI4KyuDhwAwzcJotKg0eKkGZYYZxKgDyGEYvQej1QhmxP6SvT357kv-cWivdLtIAZfFJ8wHck250kYoWDX0zT_oXT6UNlSjVmqwQglxpNSJCiUTFZzdvsSdLw9OCncMwZ1CcC0A9ysEp5vo9aP1Ydzh9Efy-9cb0J8AaqW0xfK3939sfwI0GJJG</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Xie, Yuxin</creator><creator>Zhu, Liya</creator><creator>Wang, Zebin</creator><creator>Zhan, Xiaojiang</creator><creator>Peng, Fenfen</creator><creator>Feng, Xiaoran</creator><creator>Zhou, Qian</creator><creator>Wu, Xianfeng</creator><creator>Wang, Xiaoyang</creator><creator>Su, Ning</creator><creator>Tang, Xingming</creator><creator>Zhang, Yujing</creator><creator>Zeng, Yingsi</creator><creator>Li, Mengmeng</creator><creator>Liang, Jianbo</creator><creator>Liu, Lingling</creator><creator>Wen, Yueqiang</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20220301</creationdate><title>ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients</title><author>Xie, Yuxin ; Zhu, Liya ; Wang, Zebin ; Zhan, Xiaojiang ; Peng, Fenfen ; Feng, Xiaoran ; Zhou, Qian ; Wu, Xianfeng ; Wang, Xiaoyang ; Su, Ning ; Tang, Xingming ; Zhang, Yujing ; Zeng, Yingsi ; Li, Mengmeng ; Liang, Jianbo ; Liu, Lingling ; Wen, Yueqiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-5c73f9ad4a897bf291ca7c77df054e9e247a128258f70b4c7188baa7542b75be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Angiotensin</topic><topic>Angiotensin II</topic><topic>Angiotensin-converting enzyme inhibitors</topic><topic>Bleeding</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Peptidyl-dipeptidase A</topic><topic>Peritoneal dialysis</topic><topic>Peritoneum</topic><topic>Renal function</topic><topic>Statistical analysis</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xie, Yuxin</creatorcontrib><creatorcontrib>Zhu, Liya</creatorcontrib><creatorcontrib>Wang, Zebin</creatorcontrib><creatorcontrib>Zhan, Xiaojiang</creatorcontrib><creatorcontrib>Peng, Fenfen</creatorcontrib><creatorcontrib>Feng, Xiaoran</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Wu, Xianfeng</creatorcontrib><creatorcontrib>Wang, Xiaoyang</creatorcontrib><creatorcontrib>Su, Ning</creatorcontrib><creatorcontrib>Tang, Xingming</creatorcontrib><creatorcontrib>Zhang, Yujing</creatorcontrib><creatorcontrib>Zeng, Yingsi</creatorcontrib><creatorcontrib>Li, Mengmeng</creatorcontrib><creatorcontrib>Liang, Jianbo</creatorcontrib><creatorcontrib>Liu, Lingling</creatorcontrib><creatorcontrib>Wen, Yueqiang</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xie, Yuxin</au><au>Zhu, Liya</au><au>Wang, Zebin</au><au>Zhan, Xiaojiang</au><au>Peng, Fenfen</au><au>Feng, Xiaoran</au><au>Zhou, Qian</au><au>Wu, Xianfeng</au><au>Wang, Xiaoyang</au><au>Su, Ning</au><au>Tang, Xingming</au><au>Zhang, Yujing</au><au>Zeng, Yingsi</au><au>Li, Mengmeng</au><au>Liang, Jianbo</au><au>Liu, Lingling</au><au>Wen, Yueqiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>26</volume><issue>3</issue><spage>278</spage><epage>285</epage><pages>278-285</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><abstract>Background
Gastrointestinal bleeding (GIB) is widespread in patients with impaired renal function. Whether angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) potentially take a crucial role in avoiding GIB incidence among peritoneal dialysis (PD) patients is unknown.
Methods
Overall, 734 PD patients were enrolled after using propensity score matching. Kaplan–Meier analysis and COX regression were used to explore correlation between ACEi/ARBs and GIB. Competitive risk model was aimed to identify whether other events were confounding factors. Forest plot was applied to assess the influence of ACEI/ARBs on GIB incidence in different groups.
Results
During 8-year follow-up, 89 (12.13%) cases of GIB were recorded. Kaplan–Meier analysis revealed that the incidence of GIB among patients taking ACEi/ARBs was lower than those subjects who had not (log rank = 6.442,
P
= 0.011). After adjusted different confounding factors, administration of ACEi/ARBs was associated with lowered GIB incidence (adjusted HR = 0.49, 95% CI 0.32–0.77,
P
= 0.002). In competitive risk model, considering of other events, the incidence of GIB in two groups was still statistically significant (
P
= 0.010). Subgroup analysis showed ACEi/ARBs taking impeded GIB in the ≥ 60 age group (HR = 0.52, 95% CI 0.28–0.98,
P
= 0.040).
Conclusion
PD patients who were submitted to ACEi/ARBs inclined to have a lower risk for GIB. In this regard, ACEi/ARBs offered a promising choice to GIB.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>34698915</pmid><doi>10.1007/s10157-021-02150-4</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Clinical and experimental nephrology, 2022-03, Vol.26 (3), p.278-285 |
| issn | 1342-1751 1437-7799 |
| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Angiotensin Angiotensin II Angiotensin-converting enzyme inhibitors Bleeding Medicine Medicine & Public Health Nephrology Original Article Peptidyl-dipeptidase A Peritoneal dialysis Peritoneum Renal function Statistical analysis Urology |
| title | ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients |
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