{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T09:29:46Z","timestamp":1793870986671,"version":"4.6.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020141","name":"Akebia Therapeutics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020141","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eli Lilly"},{"DOI":"10.13039\/501100015002","name":"Relypsa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006484","name":"Vifor Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006484","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Lexicon"},{"name":"Reata"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Angiotensin-converting enzyme inhibitors (ACEIs) and\/or angiotensin receptor blockers (ARBs) are recommended by guidelines as first-line antihypertensive therapies in the general population or in patients with earlier stages of kidney disease. However, the cardioprotective benefit of these agents among patients on dialysis remains uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched the MEDLINE, PubMed and Cochrane databases from inception through February 2022 to identify randomized controlled trials (RCTs) comparing the efficacy of ACEIs\/ARBs relative to placebo or no add-on treatment in patients receiving dialysis. RCTs were eligible if they assessed fatal or non-fatal cardiovascular events as a primary efficacy endpoint.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified five RCTs involving 1582 dialysis patients. Compared with placebo or no add-on treatment, the use of ACEIs\/ARBs was not associated with a significantly lower risk of cardiovascular events {risk ratio [RR] 0.79 [95% confidence interval (CI) 0.57\u20131.11]}. Furthermore, there was no benefit in cardiovascular mortality [RR 0.82 (95% CI 0.59\u20131.14)] and all-cause mortality [RR 0.86 (95% CI 0.64\u20131.15)]. These results were consistent when the included RCTs were stratified by subgroups, including hypertension, ethnicity, sample size, duration of follow-up and quality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The present meta-analysis showed that among patients on dialysis, the use of ACEIs\/ARBs is not associated with a significantly lower risk of cardiovascular events and all-cause mortality as compared with placebo or no add-on treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfac253","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T15:09:36Z","timestamp":1662563376000},"page":"203-211","source":"Crossref","is-referenced-by-count":10,"title":["Effect of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on cardiovascular outcomes in dialysis patients: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"38","author":[{"given":"Panagiotis I","family":"Georgianos","sequence":"first","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tziatzios","sequence":"additional","affiliation":[{"name":"2nd Department of Gastroenterology , Iatriko Athinon, Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanos","family":"Roumeliotis","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios","family":"Vaios","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Sgouropoulou","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios G","family":"Tsalikakis","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, University of Western Macedonia , Kozani , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios","family":"Liakopoulos","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"2023012314402973400_bib1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/S0002-9343(03)00366-8","article-title":"Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States","volume":"115","author":"Agarwal","year":"2003","journal-title":"Am J Med"},{"key":"2023012314402973400_bib2","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1161\/HYPERTENSIONAHA.109.144899","article-title":"Blood pressure and mortality among hemodialysis patients","volume":"55","author":"Agarwal","year":"2010","journal-title":"Hypertension"},{"key":"2023012314402973400_bib3","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1159\/000331067","article-title":"Epidemiology of interdialytic ambulatory hypertension and the role of volume excess","volume":"34","author":"Agarwal","year":"2011","journal-title":"Am J Nephrol"},{"key":"2023012314402973400_bib4","first-page":"211","article-title":"Blood pressure and mortality in long-term hemodialysis-time to move forward","volume":"30","author":"Georgianos","year":"2017","journal-title":"Am J Hypertens"},{"key":"2023012314402973400_bib5","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1161\/HYPERTENSIONAHA.108.125674","article-title":"Dry-weight reduction in hypertensive hemodialysis patients (DRIP): a randomized, controlled trial","volume":"53","author":"Agarwal","year":"2009","journal-title":"Hypertension"},{"key":"2023012314402973400_bib6","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1038\/nrneph.2016.129","article-title":"Epidemiology, diagnosis and management of hypertension among patients on chronic dialysis","volume":"12","author":"Georgianos","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"2023012314402973400_bib7","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1161\/HYPERTENSIONAHA.108.128116","article-title":"Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis","volume":"53","author":"Agarwal","year":"2009","journal-title":"Hypertension"},{"key":"2023012314402973400_bib8","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/S0140-6736(09)60212-9","article-title":"Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials","volume":"373","author":"Heerspink","year":"2009","journal-title":"Lancet North Am Ed"},{"key":"2023012314402973400_bib9","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2023012314402973400_bib10","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J Hypertens"},{"key":"2023012314402973400_bib11","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s11906-010-0137-z","article-title":"Should all hypertensive dialysis patients receive a blocker of the renin-angiotensin system?","volume":"12","author":"Sinha","year":"2010","journal-title":"Curr Hypertens Rep"},{"key":"2023012314402973400_bib12","doi-asserted-by":"crossref","first-page":"623","DOI":"10.2215\/CJN.07831109","article-title":"Cardiovascular effects of angiotensin converting enzyme inhibition or angiotensin receptor blockade in hemodialysis: a meta-analysis","volume":"5","author":"Tai","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"2023012314402973400_bib13","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1186\/s12882-017-0605-7","article-title":"Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on cardiovascular events and residual renal function in dialysis patients: a meta-analysis of randomised controlled trials","volume":"18","author":"Liu","year":"2017","journal-title":"BMC Nephrol"},{"key":"2023012314402973400_bib14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"2023012314402973400_bib15","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021)","author":"Higgins","year":"2021"},{"key":"2023012314402973400_bib16","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1093\/ndt\/gfs590","article-title":"Effects of angiotensin receptor blockade (ARB) on mortality and cardiovascular outcomes in patients with long-term haemodialysis: a randomized controlled trial","volume":"28","author":"Iseki","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"2023012314402973400_bib17","doi-asserted-by":"crossref","first-page":"575","DOI":"10.2215\/CJN.12940820","article-title":"Ramipril and cardiovascular outcomes in patients on maintenance hemodialysis: the ARCADIA multicenter randomized controlled trial","volume":"16","author":"Ruggenenti","year":"2021","journal-title":"Clin J Am Soc Nephrol"},{"key":"2023012314402973400_bib18","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1053\/j.ajkd.2008.04.031","article-title":"Effect of angiotensin receptor blockers on cardiovascular events in patients undergoing hemodialysis: an open-label randomized controlled trial","volume":"52","author":"Suzuki","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"2023012314402973400_bib19","doi-asserted-by":"crossref","first-page":"2507","DOI":"10.1093\/ndt\/gfl293","article-title":"Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis\u2014a randomized study","volume":"21","author":"Takahashi","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"2023012314402973400_bib20","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1038\/sj.ki.5001657","article-title":"Prevention of cardiovascular events in end-stage renal disease: results of a randomized trial of fosinopril and implications for future studies","volume":"70","author":"Zannad","year":"2006","journal-title":"Kidney Int"},{"key":"2023012314402973400_bib21","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2215\/CJN.01891105","article-title":"Pre- and postdialysis blood pressures are imprecise estimates of interdialytic ambulatory blood pressure","volume":"1","author":"Agarwal","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"2023012314402973400_bib22","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1159\/000206698","article-title":"Home blood pressure measurements for managing hypertension in hemodialysis patients","volume":"30","author":"Agarwal","year":"2009","journal-title":"Am J Nephrol"},{"key":"2023012314402973400_bib23","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/ndt\/gft515","article-title":"Hypertension in hemodialysis patients treated with atenolol or lisinopril: a randomized controlled trial","volume":"29","author":"Agarwal","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"2023012314402973400_bib24","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1001\/archinte.1974.00320180177015","article-title":"Hypertension in chronic renal failure. Treatment with hemodialysis and nephrectomy","volume":"133","author":"Lazarus","year":"1974","journal-title":"Arch Intern Med"},{"key":"2023012314402973400_bib25","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1056\/NEJM199212313272704","article-title":"Sympathetic overactivity in patients with chronic renal failure","volume":"327","author":"Converse","year":"1992","journal-title":"N Engl J Med"},{"key":"2023012314402973400_bib26","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1161\/hc1102.105261","article-title":"Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease","volume":"105","author":"Zoccali","year":"2002","journal-title":"Circulation"},{"key":"2023012314402973400_bib27","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1161\/CIRCULATIONAHA.117.027338","article-title":"Cardiovascular outcome trials in patients with advanced kidney disease: time for action","volume":"135","author":"Zannad","year":"2017","journal-title":"Circulation"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfac253\/46107074\/gfac253.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/38\/1\/203\/48830590\/gfac253.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/38\/1\/203\/48830590\/gfac253.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T14:54:44Z","timestamp":1674485684000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/38\/1\/203\/6693715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,7]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,9,7]]},"published-print":{"date-parts":[[2023,1,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfac253","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1]]},"published":{"date-parts":[[2022,9,7]]}}}