← Antihypertensives × kidney outcomes

Observational studyBMC nephrology2016

The importance of proteinuria and prior cardiovascular disease in all major clinical outcomes of atherosclerotic renovascular disease - a single-center observational study.

Diana Vassallo et al.PubMed ↗Full text ↗Publisher ↗

  • Higher estimated glomerular filtration rate at time of diagnosislooks good hereFewer deaths.Correlation only, not a test of it.
  • Renin angiotensin blockade (RAB) at baselinelooks good hereFewer deaths, no clear link with ESKD.Correlation only, not a test of it.
  • Statins at baselinelooks good hereFewer deaths, lower ESKD.Correlation only, not a test of it.
  • Revascularizationlooks good hereFewer deaths, lower ESKD.Correlation only, not a test of it.

What moved togetherboth groups pooled, not the treatment’s effect

Correlation, not cause

Higher estimated glomerular filtration rate at time of diagnosis went with fewer deaths

−8%−11% to −6%

Higher estimated glomerular filtration rate at time of diagnosis vs Lower estimated glomerular filtration rate at time of diagnosis

Bigger than 2 in 10 for all-cause mortality

As reported

HR 0.92, 95% CI 0.89–0.94 · the paper's word: Death

Correlation, not cause

Renin angiotensin blockade (RAB) at baseline went with fewer deaths

−17%−30% to −2%

Renin angiotensin blockade (RAB) at baseline vs No renin angiotensin blockade at baseline

Bigger than 5 in 10 for all-cause mortality

As reported

HR 0.83, 95% CI 0.70–0.98 · the paper's word: Death

Correlation, not cause

Statins at baseline went with fewer deaths

−21%−34% to −6%

Statins at baseline vs No statins at baseline

Bigger than 6 in 10 for all-cause mortality

As reported

HR 0.79, 95% CI 0.66–0.94 · the paper's word: Death

+4 more in the walkthrough ↓

Who was studied, and how

872people with cardiovascular disease, in this paper

Already taking Higher estimated glomerular filtration rate at time of diagnosis, or nottheir own situation, not assigned

on Higher estimated glomerular filtration rate at time of diagnosis
Lower estimated glomerular filtration rate at time of diagnosis

Higher estimated glomerular filtration rate at time of diagnosis went with fewer deaths−8%

correlation, not a test

Already taking Renin angiotensin blockade (RAB) at baseline, or nottheir own situation, not assigned

on Renin angiotensin blockade (RAB) at baseline
not on renin angiotensin blockade at baseline

Renin angiotensin blockade (RAB) at baseline went with fewer deaths−17%

No clear link with ESKD−16%

correlation, not a test

the abstract, start to end

… risk of all end-points (Death: HR 0.92 [95% CI 0.89-0.94])., Administration of statins and renin angiotensin blockade (RAB) at baseline were also associated with reduced adverse events, especially death (RAB: HR 0.83 [95% CI 0.70-0.98]; statins: HR 0.79 [95% CI 0.66-.94]) and ESKD (RAB: HR 0.84 [95% CI 0.71-1.00]; statins: HR 0.79 [95% CI 0.66-0.93]).

… with reduced risk of death (HR 0.65 [95% CI 0.51-0.83]) and ESKD (HR 0.59 [95% CI 0.46-0.76]).

← favours treatmentfavours comparator →
could be chance
DeathHigher estimated glomerular filtration rate at time of diagnosis vs Lower estimated glomerular filtration rate at time of diagnosis
HR 0.920.89–0.94
DeathRenin angiotensin blockade (RAB) at baseline vs No renin angiotensin blockade at baseline
HR 0.830.70–0.98
DeathStatins at baseline vs No statins at baseline
HR 0.790.66–0.94
ESKDStatins at baseline vs No statins at baseline
HR 0.790.66–0.93
ESKDRenin angiotensin blockade (RAB) at baseline vs No renin angiotensin blockade at baseline
HR 0.840.71–1.00
DeathRevascularization vs No revascularization
HR 0.650.51–0.83
ESKDRevascularization vs No revascularization
HR 0.590.46–0.76
StatinsAntihypertensivesCardiac procedures & devicesAll-cause mortalityKidney outcomes
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Full record →Abstract, authors, funding and every citing paper · PMID 27927187