Cardiovascular disease is a leading cause of death in patients with end-stage renal disease (ESRD). Hypertension is a major risk factor for cardiovascular complications in these patients. Angiotensin-converting enzyme (ACE) inhibitors are an effective treatment for hypertension in patients with ESRD and are known to improve prognosis in patients with chronic renal failure.
Hard to give a definitive answer as although CD is a big factor in hemodialysis mortality, prescription of ACEIs can cause hyperkalimia in a population already subjected to a high risk of hyperkalimia. Use of other drugs with ACEIs to reduce hyperkalima have been investigated also. it might be worth reading..
J Am Coll Cardiol. 2013 Nov 6.10.1016/j.jacc.2013.10.050. [Epub ahead of print]
ACE Inhibitor and Angiotensin Receptor Blocker Use and Mortality in Patients with Chronic Kidney Disease.
Molnar MZ, Kalantar-Zadeh K, Lott EH, Lu JL, Malakauskas SM, Ma JZ, Quarles DL, Kovesdy CP.
I'm working with ARCADIA study which address this tool. A groug of hemodialysis patient are taking ramipril matched with a group treated by placebo to investigate on cardiovascular and mortality end points.
