The angiotensin converting enzyme (ACE) inhibitor is a drug, ramipril, particularly effectively in that in an upcoming issue of the journal of the American Society of Nephrology (JASN) reduce the risk of end-stage renal disease (ESRD) in obese patients, according to a study.
"Obese patients with kidney disease progress faster renal failure when compared to non-obese patients and ramipril practically this excess risk creates" comments Carmine Zoccali, MD (CNR – and Ospedali riuniti di Reggio Calabria, Italy).
The researchers analyzed data from a previous study comparing ramipril with an inactive placebo in patients with non-diabetes related chronic kidney disease (CKD) 337. rates of progression to ESRD on the two treatments were in overweight and obese patients versus normal weight patients compared.
Placebo, the risk of developing ESRD was more than twice as high for obese patients compared with normal weight patients: 24 versus 10 per 100 person years. For patients who were overweight but not obese, ESRD risk in normal weight was comparable to patients.
Ramipril lowered the risk of progression to ESRD in all three weight groups. The extent of the risk reduction was however higher in obese patients: 86 per cent, compared to 45 percent for normal weight patients. So the ramipril on the same risk as normal weight was patient with end-stage renal disease, obese patients.
"Obesity is the most common cause of CKD, now" so Zoccali. "In the United States, one of four patients dialysis from overweight is." Ramipril and other ACE inhibitors are commonly for the treatment of chronic kidney disease in patients with high levels of protein in the urine (proteinuria), such as that used in the study.
"Our results strongly indicate that ACE inhibitors preferred to use in obese patients, move to kidney disease in the most advanced stages to prevent" includes Zoccali. It calls for further analysis of the results, and especially for obese patients with chronic kidney disease, new studies confirm.
The study can be considered a new analysis of a previous clinical trial as final proof, that ACE inhibitors have special in obese patients with chronic kidney disease. Furthermore, the study focuses on kidney disease associated with high proteinuria; It is unknown whether ACE inhibitors will have the same protective effect in patients with lower levels of proteinuria. In addition, the patients were all white Europeans; the results must be confirmed in studies other ethnic groups there.
The authors reported no financial information.
Source: American Society of Nephrology (ASN)
source:medicalnewstoday
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