{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:48:59Z","timestamp":1787017739537,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-108-225"],"award-info":[{"award-number":["DMR-108-225"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["MOHW106-TDU-B-212-113004"],"award-info":[{"award-number":["MOHW106-TDU-B-212-113004"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["DMR-108-225"],"award-info":[{"award-number":["DMR-108-225"]}],"id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["MOHW106-TDU-B-212-113004"],"award-info":[{"award-number":["MOHW106-TDU-B-212-113004"]}],"id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gastroenterology Research and Practice"],"published-print":{"date-parts":[[2019,10,10]]},"abstract":"<jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    The use of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) carries a risk of renal function deterioration in cirrhotic patients with ascites. However, whether the long-term use of ACEis\/ARBs is safe in cirrhotic patients without ascites remains unknown.\n                    <jats:italic>Methods.<\/jats:italic>\n                    In this nationwide cohort study, we identified 311,361 newly diagnosed cirrhotic patients between January 1997 and December 2013. To avoid indication and immortal time biases, patients receiving regular ACEi\/ARB therapy, defined as the ACEi\/ARB cohort, were matched to patients receiving regular calcium channel blockers (CCBs), defined as the CCB cohort, at a ratio of 1\u2009:\u20091 by age, sex, and propensity scores for comorbidities and medications (2,188 patients in each cohort). Cumulative incidence rates and multivariate analyses of end-stage renal disease (ESRD) risk were adjusted for competing mortality.\n                    <jats:italic>Results.<\/jats:italic>\n                    The 10-year cumulative incidence rates of ESRD were 2.32% (95% confidence interval [CI]: 1.45\u20133.20) in the ACEi\/ARB cohort and 1.70% (95% CI: 1.03\u20132.36) in the CCB cohort (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                      <mml:mi>P<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.610<\/mml:mn>\n                    <\/mml:math>\n                    ). In multivariate analyses, ACEi\/ARB use was not associated with a higher risk of ESRD in cirrhotic patients (hazard ratio\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                      <mml:mfenced open=\"[\" close=\"]\">\n                        <mml:mrow>\n                          <mml:mtext>HR<\/mml:mtext>\n                        <\/mml:mrow>\n                      <\/mml:mfenced>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>1.15<\/mml:mn>\n                    <\/mml:math>\n                    ; 95% CI: 0.69\u20131.94,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                      <mml:mi>P<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.591<\/mml:mn>\n                    <\/mml:math>\n                    ). In the sensitivity test, the 10-year cumulative incidence rates of ESRD in cirrhotic patients with ascites were 6.50% (95% CI: 0.54\u201312.46) and 1.24% (95% CI: 0.00\u20132.71) in ACEi\/ARB and CCB cohorts, respectively (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                      <mml:mi>P<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mn>0.090<\/mml:mn>\n                    <\/mml:math>\n                    ).\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    Long-term ACEi\/ARB use was not associated with a higher risk of ESRD in cirrhotic patients. However, the risk of ESRD tended to increase in cirrhotic patients with ascites.\n                  <\/jats:p>","DOI":"10.1155\/2019\/1743290","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T19:30:17Z","timestamp":1570735817000},"page":"1-8","source":"Crossref","is-referenced-by-count":15,"title":["Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0738-417X","authenticated-orcid":true,"given":"Wei-Fan","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Hang","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaw-Town","family":"Lin","sequence":"additional","affiliation":[{"name":"Digestive Medicine Center, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaw-Ching","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan"},{"name":"Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chih","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-5425","authenticated-orcid":true,"given":"Yi-Hsiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-1801","authenticated-orcid":true,"given":"Chun-Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan"},{"name":"Division of Gastroenterology & Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Department of Public Health, China Medical University, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-6086","authenticated-orcid":true,"given":"Cheng-Yuan","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250145"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.06.004"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91740-3"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510290203"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.26295"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.26288"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0809139"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26359"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.004"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011303"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1007994"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)11445-8"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71082-5"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61236-2"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-1-200907070-00122"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11975"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.0695"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26300"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.03.048"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26892"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.236133"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2012.02807.x"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.12.029"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-307526"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001999"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13115"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1612334"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001362"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-7-200104030-00010"},{"key":"31","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.10.007"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.09.016"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.02.005"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.03.013"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv003"},{"key":"36","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003013"}],"container-title":["Gastroenterology Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/grp\/2019\/1743290.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/grp\/2019\/1743290.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/grp\/2019\/1743290.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T19:30:19Z","timestamp":1570735819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/grp\/2019\/1743290\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,10]]},"references-count":36,"alternative-id":["1743290","1743290"],"URL":"https:\/\/doi.org\/10.1155\/2019\/1743290","relation":{},"ISSN":["1687-6121","1687-630X"],"issn-type":[{"value":"1687-6121","type":"print"},{"value":"1687-630X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,10]]}}}