Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 6 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.

Longer predialysis ACEi/ARB exposure lowers postdialysis mortality

06 Sep 2020

Longer predialysis use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEi/ARB) results in reduced postdialysis mortality, reveals a study.

“ACEi/ARB improve predialysis outcomes,” the investigators said. “[H]owever, ACEi/ARB are underused in patients transitioning to dialysis.”

To determine the association of different patterns of predialysis ACEi/ARB use with postdialysis survival and whether potentially modifiable adverse events are associated with lower predialysis ACEi/ARB use, a cohort study was performed on 34,676 US veterans with and 10,690 without ACEi/ARB exposure in the 3-year predialysis period who then transitioned to dialysis between 2007 and 2014.

Multivariable-adjusted regression analyses were then carried out to examine the associations of different patterns of predialysis ACEi/ARB use with postdialysis all-cause mortality and with predialysis acute kidney injury and hyperkalaemia events. Participants had a mean age of 70 years, of whom 98 percent were males and 27 percent were African Americans.

Continuous use of ACEI/ARB vs nonuse correlated with reduced postdialysis all-cause mortality (adjusted hazard ratio [aHR], 0.87, 95 percent confidence interval [CI], 0.83–0.92).

Likewise, analyses modeling the duration of predialysis ACEi/ARB use showed that ACEi/ARB use of 50–74 percent (aHR, 0.96, 95 percent CI, 0.92–0.99) and ≥75 percent (aHR, 0.91, 95 percent CI, 0.88–0.94) correlated with lower mortality compared to nonuse. Conversely, shorter predialysis use of ACEi/ARB did not increase postdialysis survival.

Furthermore, shorter duration (<50 percent) of ACEi/ARB use correlated with predialysis acute kidney injury, while interrupted and ACEi/ARB use <75 percent correlated with hyperkalaemia.

“Prospective studies are needed to evaluate the benefits of strategies enabling uninterrupted predialysis ACEi/ARB use,” the investigators said.

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Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 6 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.