{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:11:42Z","timestamp":1765876302047,"version":"3.48.0"},"reference-count":47,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,25]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study determined the comparative renal functions on patients with diabetes treated with ACE inhibitors (ACEIs) plus either thiazide diuretics or calcium channel blockers (CCBs) in Northwestern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study design was employed to collect the data from medical records of patients with diabetes followed for 1\u20135 years (N=404).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The medical records of patients in chronic diabetic follow-up clinics of the hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All the patients with diabetes medical records in Northwestern Ethiopian specialised hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Exposures were ACEIs plus thiazide diuretics or CCBs collected from March to June 2020. Outcomes were defined as declining in estimated glomerular filtration rate (eGFR) values by \u226530% from the baseline recorded from 2015 to 2019. Descriptive and analytical statistics were illustrated to compare the study groups. Kaplan-Meier with log- rank test was used to plot the survival analyses curve. Potential factors substantially associated to renal events were examined using cox proportional hazards model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      About 20% of patients developed renal events and significant numbers were from hydrochlorothiazide (HCT) users. The mean eGFR levels were significantly higher in patients on CCBs users over the follow-up years compared with HCT-based users. The CCBs users had an 18.8 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      higher in eGFR levels at the end of the follow-up period than HCT users (p&lt;0.001). HCT users had shorter survival probability overtime to develop the outcomes compared with CCBs users (p=0.003). The CCBs-based regimen prevented risks of declining in renal function by 56.4% than HCT (p=0.001). Hazards of declining in eGFR levels were 93% higher for the patients with initial systolic blood pressure (SBP) levels were more than 150 mm Hg (p=0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with HCT, patients on CCBs had significantly prevented risks of renal events. However, both groups appeared with the same cardiovascular events. HCT-based regimen and higher initial SBP levels were significantly associated with eGFR reductions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048442","type":"journal-article","created":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T11:37:12Z","timestamp":1637840232000},"page":"e048442","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Renal outcomes of diabetic patients treated with combination therapy of ACE inhibitors plus either thiazide diuretics or calcium channel blockers: comparative retrospective cohort study in Northwestern Ethiopia"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0519-509X","authenticated-orcid":false,"given":"Adeladlew Kassie","family":"Netere","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1976-4388","authenticated-orcid":false,"given":"Esmael Ali","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition Institute of Public Health, University of Gondar, Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mezgebu Silamsaw","family":"Asres","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Gondar, Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masho Tigabie","family":"Teklie","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"2025121601073562000_11.11.e048442.1","unstructured":"Knott. 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