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ACEi/ARBs associate with lower incidence of gastrointestinal bleeding in peritoneal dialysis patients

Yuxin Xie1, Liya Zhu1, Zebin Wang1

  • 1Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Clinical and Experimental Nephrology
|October 26, 2021
PubMed

Insights

Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) significantly reduced gastrointestinal bleeding (GIB) risk in peritoneal dialysis (PD) patients. These medications offer a promising strategy for preventing GIB in this vulnerable population.

Area of Science:

  • Nephrology
  • Gastroenterology
  • Pharmacology

Background:

  • Gastrointestinal bleeding (GIB) is a common complication in patients with impaired renal function.
  • The role of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARBs) in preventing GIB among peritoneal dialysis (PD) patients remains unclear.

Purpose of the Study:

  • To investigate the association between ACEi/ARBs use and the incidence of GIB in PD patients.
  • To determine if ACEi/ARBs offer a protective effect against GIB in this population.

Main Methods:

  • A cohort of 734 PD patients was analyzed using propensity score matching.
  • Kaplan-Meier analysis and COX regression were employed to assess the correlation between ACEi/ARBs and GIB.
  • Competitive risk models and subgroup analyses were conducted to control for confounding factors and evaluate specific demographics.

Main Results:

  • Over an 8-year follow-up, 89 cases of GIB were recorded.
  • Patients using ACEi/ARBs exhibited a significantly lower incidence of GIB compared to non-users (P=0.011).
  • Adjusted analyses confirmed that ACEi/ARBs were associated with a reduced risk of GIB (adjusted HR=0.49, P=0.002), particularly in patients aged 60 and above.

Conclusions:

  • Peritoneal dialysis patients treated with ACEi/ARBs demonstrated a lower propensity for GIB.
  • ACEi/ARBs represent a potentially valuable therapeutic option for mitigating GIB risk in PD patients.
Abstract

Keywords:
Angiotensin II receptor blockerAngiotensin-converting enzyme inhibitorsGastrointestinal bleedingPeritoneal dialysis

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