{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:08:54Z","timestamp":1760148534692,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Center Program","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"National Research Foundation (NRF) of Korea","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"Ministry of Science, ICT, and Future Planning","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"Basic Science Research Program","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"NRF of Korea","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"Ministry of Education","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]},{"name":"Korea government (MSIT)","award":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"],"award-info":[{"award-number":["2022R1A5A2018865","2022R1I1A3072966","2022R1F1A1076151"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Additional studies are needed to confirm whether the use of renin-angiotensin system blockers (RASBs) induces survival benefits in patients on hemodialysis (HD). This study aimed to evaluate patient survival with the use of RASBs in a large sample of maintenance HD patients. This study used data from the national HD quality assessment program and claim data from South Korea (n = 54,903). A patient using RASBs was defined as someone who had received more than one prescription during the 6 months of each HD quality assessment period. The patients were divided into three groups as follows: Group 1, no prescription for anti-hypertensive drugs; Group 2, prescription for anti-hypertensive drugs other than RASBs; and Group 3, prescription for RASBs. The five-year survival rates in Groups 1, 2, and 3 were 72.1%, 64.5%, and 66.6%, respectively (p &lt; 0.001 for Group 1 vs. Group 2 or 3; p = 0.001 for Group 2 vs. Group 3). Group 1 had the highest patient survival rates among the three groups, and Group 3 had higher patient survival rates compared to Group 2. Group 3 had higher patient survival rates than Group 2; however, the difference in patient survival rates between Group 2 and Group 3 was relatively small. Multivariate Cox regression analyses showed similar trends as those of univariate analyses. The highest survival rates from our study were those of patients who had not used anti-hypertensive drugs. Between patients treated with RASBs and those with other anti-hypertensive drugs, patient survival rates were higher in patients treated with RASBs.<\/jats:p>","DOI":"10.3390\/jcm12093301","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T02:29:22Z","timestamp":1683512962000},"page":"3301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Renin-Angiotensin System Blockers with Survival in Patients on Maintenance Hemodialysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-0195","authenticated-orcid":false,"given":"Seok Hui","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Jung","family":"Son","sequence":"additional","affiliation":[{"name":"Quality Assessment Department, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gui Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"Quality Assessment Department, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-9310","authenticated-orcid":false,"given":"Jun Young","family":"Do","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref_1","unstructured":"ESRD Registry Committee: Korean Society of Nephrology (2023, March 07). Current Renal Replacement Therapy in Korea. Available online: https:\/\/ksn.or.kr\/bbs\/index.php?code=report."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.krcp.2014.04.001","article-title":"Excess mortality among patients on dialysis: Comparison with the general population in Korea","volume":"33","author":"Choi","year":"2014","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1161\/01.HYP.17.4.589","article-title":"History of the design of captopril and related inhibitors of angiotensin converting enzyme","volume":"17","author":"Cushman","year":"1991","journal-title":"Hypertension"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group (2021). KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int., 99, S1\u2013S87.","DOI":"10.1016\/j.kint.2020.11.003"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"24","author":"McDonagh","year":"2022","journal-title":"Eur. J. Heart Fail."},{"key":"ref_7","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":"ref_8","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":"ref_9","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1053\/ajkd.2002.36340","article-title":"ACE inhibitors and survival of hemodialysis patients","volume":"40","author":"Efrati","year":"2002","journal-title":"Am. J. Kidney Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3317\/jraas.2002.040","article-title":"Mortality benefit of angiotensin-converting enzyme inhibitors after cardiac events in patients with end-stage renal disease","volume":"3","author":"McCullough","year":"2002","journal-title":"J. Renin Angiotensin Aldosterone Syst."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0735-1097(03)00572-2","article-title":"Aspirin, beta-blocker, and angiotensin-converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction","volume":"42","author":"Berger","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.kint.2018.03.013","article-title":"DOPPS data suggest a possible survival benefit of renin angiotensin-aldosterone system inhibitors and other antihypertensive medications for hemodialysis patients","volume":"94","author":"Karaboyas","year":"2018","journal-title":"Kidney Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1007\/s40620-022-01356-3","article-title":"Clinical significance of hemodialysis quality of care indicators in very elderly patients with end stage kidney disease","volume":"35","author":"Kim","year":"2022","journal-title":"J. Nephrol."},{"key":"ref_14","unstructured":"Health Insurance Review & Assessment Service (2023, March 07). 6th Hemodialysis Quality Assessment Program. Available online: https:\/\/www.hira.or.kr\/bbsDummy.do?pgmid=HIRAA020002000100&brdScnBltNo=4&brdBltNo=6619#none."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1681\/ASN.V451205","article-title":"Second generation logarithmic estimates of single-pool variable volume Kt\/V: An analysis of error","volume":"4","author":"Daugirdas","year":"1993","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.2337\/dc08-0371","article-title":"Preventing left ventricular hypertrophy by ACE inhibition in hypertensive patients with type 2 diabetes: A prespecified analysis of the Bergamo Nephrologic Diabetes Complications Trial (BENEDICT)","volume":"31","author":"Ruggenenti","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/0272-6386(95)90128-0","article-title":"Plasma renin activity in hemodialyzed patients during long-term follow-up","volume":"25","author":"Kimura","year":"1995","journal-title":"Am. J. Kidney Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1159\/000368537","article-title":"Some Aspects of the Renin-Angiotensin-System in Hemodialysis Patients","volume":"40","author":"Malik","year":"2015","journal-title":"Kidney Blood Press Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e009429","DOI":"10.1161\/JAHA.118.009429","article-title":"Hyperkalemia in Heart Failure: Probably Not O\u201cK\u201d","volume":"7","author":"Fudim","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_22","first-page":"1295","article-title":"Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: The Metoprolol CR\/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF)","volume":"283","author":"Hjalmarson","year":"2000","journal-title":"MERIT-HF Study Group. JAMA"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1067\/mhj.2002.120768","article-title":"Bisoprolol for the treatment of chronic heart failure: A meta-analysis on individual data of two placebo-controlled studies\u2014CIBIS and CIBIS II. Cardiac Insufficiency Bisoprolol Study","volume":"143","author":"Leizorovicz","year":"2002","journal-title":"Am. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jacc.2014.04.042","article-title":"\u03b2-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease","volume":"64","author":"Andersson","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1001\/archinte.164.22.2465","article-title":"\u03b2-Blocker use in long-term dialysis patients: Association with hospitalized heart failure and mortality","volume":"164","author":"Abbott","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1080\/07853890.2022.2098376","article-title":"\u03b2-blocker treatment in the critically ill: A systematic review and meta-analysis","volume":"54","author":"Heliste","year":"2022","journal-title":"Ann. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100460","DOI":"10.1016\/j.xkme.2022.100460","article-title":"\u03b2-Blocker Use and Cardiovascular Outcomes in Hemodialysis: A Systematic Review","volume":"4","author":"Tella","year":"2022","journal-title":"Kidney Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1681\/ASN.2014040324","article-title":"\u03b2-Blocker dialyzability and mortality in older patients receiving hemodialysis","volume":"26","author":"Weir","year":"2015","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Shireman, T.I., Mahnken, J.D., Phadnis, M.A., and Ellerbeck, E.F. (2016). Effectiveness comparison of cardio-selective to non-selective \u03b2-blockers and their association with mortality and morbidity in end-stage renal disease: A retrospective cohort study. BMC Cardiovasc. Disord., 16.","DOI":"10.1186\/s12872-016-0233-3"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.jacc.2011.04.041","article-title":"Effects of beta-adrenergic antagonists in patients with chronic kidney disease: A systematic review and meta-analysis","volume":"58","author":"Badve","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.2215\/CJN.11331210","article-title":"Cardiovascular and noncardiovascular mortality among men and women starting dialysis","volume":"6","author":"Carrero","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1291\/hypres.21.279","article-title":"Lisinopril decreases plasma free testosterone in male hypertensive patients and increases sex hormone binding globulin in female hypertensive patients","volume":"21","author":"Koshida","year":"1998","journal-title":"Hypertens Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/ndt\/gfh638","article-title":"Renin-angiotensin blockade reduces serum free testosterone in middle-aged men on haemodialysis and correlates with erythropoietin resistance","volume":"20","author":"DeLong","year":"2005","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1681\/ASN.2008060664","article-title":"Low serum testosterone increases mortality risk among male dialysis patients","volume":"20","author":"Carrero","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.2215\/CJN.03600410","article-title":"Endogenous testosterone and mortality in male hemodialysis: Is it the results of aging?","volume":"5","author":"Gungor","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/9\/3301\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:30:03Z","timestamp":1760124603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/9\/3301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,5]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["jcm12093301"],"URL":"https:\/\/doi.org\/10.3390\/jcm12093301","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,5,5]]}}}