No Differences in Outcomes Among Peritoneal Dialysis Drugs

Two common classes of medications that prevent cardiovascular events were found to have no significant difference in outcomes, during a recent study.

Although angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) are prescribed for the same conditions, they have slightly different mechanisms and therefore could theoretically have different outcomes.

In a study published in the Journal of Nephrology, researchers wanted to examine these 2 classes of drugs side by side to determine their efficacy.

“Despite this suggestion, we could find no previous study that had compared these 2 classes of medications head-to-head in patients on peritoneal dialysis to see if ACEI might indeed be better than ARB in this patient population,” said lead researcher and corresponding study author Jenny Shen, MD.

The researchers wrote that prior studies suggest “ACEI may lead to a kinin-mediated increase in insulin sensitivity not seen with ARB. This could potentially lower the cardiovascular risk in patients on peritoneal dialysis because they are exposed to high glucose loads [in their dialysate] that may lead to insulin resistance and its associated cardiovascular risk.”

For the study, researchers used a national database called the US Renal Data System to collect records for Medicare Part D patients who underwent peritoneal dialysis from 2007 to 2011. They found 1892 patients who used either drug class.

The results of the study showed no differences in cardiovascular events or deaths between users for each medication class.

“Our study found no significant difference in the effectiveness of the 2 classes of medications,” Shen said. “Although randomized clinical trials would be needed to confirm these observational results, our study suggests that physicians can use ACEI and ARB interchangeably to prevent cardiovascular risks in their peritoneal dialysis patients.”