ArticleAmerican journal of nephrology2016
Obesity, Renin-Angiotensin System Blockade and Risk of Adverse Renal Outcomes: A Population-Based Cohort Study.
Article in American journal of nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Gene-Diet Interactions on Metabolic Disease-Related Outcomes in Southeast Asian Populations: A Systematic Review.Nutrients · 2023Pooled it
- Risk of incident chronic kidney disease is better reduced by bedtime than upon-awakening ingestion of hypertension medications.Hypertension research : official journal of the Japanese Society of Hypertension · 2018Trial
- How to individualize renoprotective therapy in obese patients with chronic kidney disease: a commentary by the Diabesity Working Group of the ERA.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Mechanisms and treatment of obesity-related hypertension-Part 2: Treatments.Clinical kidney journal · 2025Review
- Role of obesity in chronic kidney disease progression.Current research in physiology · 2025Review
- Precision Nephrology in Patients with Diabetes and Chronic Kidney Disease.International journal of molecular sciences · 2022Review
- High-normal albuminuria is strongly associated with incident chronic kidney disease in a nondiabetic population with normal range of albuminuria and normal kidney function.Clinical and experimental nephrology · 2020Article
- New BenzofuranDrug design, development and therapy · 2020Article
- Weight Loss Medications in the Treatment of Obesity and Hypertension.Current hypertension reports · 2019Review
- Regulation and Functions of the Renin-Angiotensin System in White and Brown Adipose Tissue.Comprehensive Physiology · 2017Review
- Hypertension in Obesity and the Impact of Weight Loss.Current cardiology reports · 2017Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundObesity substantially increases the risk of the development of chronic kidney disease. Adipose tissue expresses all of the components of the renin-angiotensin system (RAS), contributing to the high prevalence of hypertension in obese patients and driving renal hyperfiltration and subsequent glomerular injury.
methodsWe performed a retrospective cohort study using a United Kingdom primary care database, evaluating the effect of time-updated exposure to RAS blockade versus all other antihypertensive medications in obese, hypertensive, non-diabetic patients. We used Cox proportional hazards modeling with and without marginal structural modeling to assess the hazards of developing a primary outcome of 50% reduction in estimated glomerular filtration rate (eGFR) (across 2 consecutive values), end stage renal disease or death.
resultsA total of 219,701 patients met inclusion criteria, with a median 7.2 years of follow-up. Median baseline eGFR was 72.6 ml/min/1.73 m2. Compared to other antihypertensive medications, patients treated with RAS blockade had a modestly elevated hazard of adverse renal outcomes using traditional Cox regression (hazard ratio (HR) 1.04, 95% CI 1.01-1.07) and no significantly increased hazard by marginal structural modeling (HR 1.02, 95% CI 0.97-1.08). Patients treated with RAS blockade had a significantly reduced hazard of incident diabetes, but no significant difference in mortality.
conclusionThis study, conducted in a large real-world cohort, provides evidence that RAS blockade may not provide benefit with regard to longitudinal renal outcomes in obese, hypertensive patients. Further research is needed to elucidate the hemodynamic and renoprotective role of antihypertensive medications in obese patients.
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