Improving prognosis in chronic kidney disease

Date:
March 23, 2022
Source:
Osaka University
Summary:
Researchers have conducted a retrospective study of over 3100
people with chronic kidney disease to evaluate the association
between mineralocorticoid receptor antagonist (MRA) use and
renal outcomes. The analysis revealed an association between MRA
use and a reduced risk for the initiation of renal replacement
therapy across multiple subgroups of patients with chronic kidney
disease. These findings reinforce the use of MRAs in treatment
plans for various groups of people with chronic kidney disease
who are not undergoing dialysis.



FULL STORY ==========================================================================
Just as a water filtration system acts to filter contaminants from the
water you drink, your kidneys act to filter waste and excess fluid from
your blood.

In chronic kidney disease (CKD), kidney function is impaired over
time, and the resultant build-up of excess fluid and waste has harmful repercussions on overall body function. Researchers in Japan conducted
a study of real-world data from patients with CKD to evaluate the impact
of a commonly prescribed medication on disease outcome.


==========================================================================
In a study published in Hypertension, researchers from Osaka University
have demonstrated an association between the use of mineralocorticoid
receptor antagonists (MRAs), a class of medicines that acts by suppressing
the action of the steroid hormone aldosterone, and an improved renal
prognosis in individuals with CKD.

As CKD progresses, the initiation of renal replacement therapy (RRT),
which includes dialysis and kidney transplantation, may be necessary
for life support in kidney failure. MRAs, which include spironolactone, eplerenone, and potassium canrenoate, are commonly used to reduce
swelling, blood pressure, and urine protein levels in people with
CKD. However, the association between MRA treatment and the initiation
of RRT has not been fully explored in a real-world population, which
spurred the research team from Osaka University to undertake a large-scale retrospective study of MRA use in people with CKD.

"We conducted a retrospective analysis of clinical data from over 3100 individuals with CKD," says lead author Tatsufumi Oka. "We evaluated MRA treatment in various populations of people with CKD, including those
with diabetes, heart disease, and severely impaired renal function."
The research team employed a marginal structural model to analyze the association between MRA use and the initiation of RRT across multiple
patient subgroups.

"Our analysis showed that MRA use was associated with a 28% lower rate
of RRT initiation and a 24% lower rate of the combined outcomes of RRT initiation and death," says senior author Jun-Ya Kaimori.

The research team observed a reduced risk for RRT initiation across
various subgroups of people with CKD, including those with and without
diabetes and those with severely impaired renal function. These
findings highlight the association of MRA use and improved renal
outcomes in a real-world population of CKD patients with varying health backgrounds. Overall, this study supports the use of MRAs in treatment
plans for various groups of people with CKD who are not undergoing
dialysis.


========================================================================== Story Source: Materials provided by Osaka_University. Note: Content may
be edited for style and length.


========================================================================== Journal Reference:
1. Tatsufumi Oka, Yusuke Sakaguchi, Koki Hattori, Yuta Asahina, Sachio
Kajimoto, Yohei Doi, Jun-Ya Kaimori, Yoshitaka
Isaka. Mineralocorticoid Receptor Antagonist Use and
Hard Renal Outcomes in Real-World Patients With Chronic
Kidney Disease. Hypertension, 2022; 79 (3): 679 DOI:
10.1161/HYPERTENSIONAHA.121.18360 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220323093641.htm

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