NDT Advance Access originally published online on June 9, 2006
Nephrology Dialysis Transplantation 2006 21(9):2507-2512; doi:10.1093/ndt/gfl293
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Dialysis and Transplantation
Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis—a randomized study
1 Department of Internal Medicine, 2 Department of Urology, Enshu General Hospital, Hamamatsu and 3 Internal Medicine and Molecular Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
Correspondence and offprint requests to: Yasuaki Dohi, MD, Internal Medicine and Molecular Science, Graduate School of Medical Sciences, Nagoya City University, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Email: ydohi{at}med.nagoya-cu.ac.jp
Background. Cardiovascular events are the major determinants of the prognosis of patients on chronic haemodialysis. The present study was designed to investigate whether candesartan, an angiotensin II type-1 receptor blocker, reduces the incidence of cardiovascular events in these patients.
Methods. A total of 80 chronic haemodialysis patients (male/female, 47/33; mean age ± SEM, 61 ± 1 years) in stable condition and with no clinical evidence of cardiac disorders were enrolled. Patients were randomly assigned candesartan 4–8 mg/day (candesartan group; n = 43) or nothing (control group; n = 37), and followed for 19.4 ± 1.2 months with as endpoint cardiovascular events such as fatal/nonfatal myocardial infarction, unstable angina pectoris, congestive heart failure, severe arrhythmia and sudden death.
Results. Both groups exhibited similar clinical characteristics at baseline. During follow-up, cardiovascular events occurred in seven patients in the candesartan group and 17 in the control group. Kaplan–Meier analysis revealed that cardiovascular events and mortality rates were significantly (P < 0.01) higher in the control group than in the candesartan group (45.9 vs 16.3% and 18.9 vs 0.0%, respectively).
Conclusions. Candesartan therapy significantly reduces cardiovascular events and mortality in patients on chronic maintenance haemodialysis and therefore improves the prognosis of these patients.
Keywords: angiotensin receptor antagonists; brain natriuretic peptide; cardiovascular disease; cardiovascular mortality; congestive heart failure; randomized trail
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