Is discontinuation of RAS inhibitors associated with a significant difference in eGFR at 3 years in patients with advanced and progressive chronic kidney disease?
Study design: Multicenter, open-label, randomized controlled trial
Population:
- Number of patients studied: 411
- Inclusion criteria: Patients with advanced and progressive chronic kidney disease (eGFR, <30 ml per minute per 1.73 m2 of body-surface area)
- Exclusion criteria: None specified
Interventions:
- Experimental group: Discontinuation of RAS inhibitors
- Control group: Continuation of RAS inhibitors
Primary outcome: eGFR at 3 years (excluding eGFR values obtained after the initiation of renal-replacement therapy)
Safety outcomes or Adverse Events
| Outcome | Discontinuation Group | Continuation Group | Hazard Ratio (95% CI) |
|---|---|---|---|
| eGFR at 3 years | 12.6±0.7 | 13.3±0.6 | -0.7 (-2.5 to 1.0); P = 0.42 |
| ESKD or initiation of renal-replacement therapy | 128 (62%) | 115 (56%) | 1.28 (0.99 to 1.65) |
| Cardiovascular events | 108 | 88 | - |
| Deaths | 20 | 22 | - |
Conclusion
Discontinuation of RAS inhibitors in patients with advanced and progressive chronic kidney disease was not associated with a significant between-group difference in the long-term rate of decrease in eGFR.