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논문분류	춘계학술대회 초록집
제목	Renin-angiotensin System Inhibitors Reduce Mortality and Allograft Loss Among Renal Transplant Recipients
저자	Yu-Hsiang Chou
출판정보	2024; 2024(1):
키워드
초록	Objectives: The blockade of the renin-angiotensin system (RAS) has a beneficial effect on reducing the levels of proteinuria and blood pressure in patients with chronic kidney disease (CKD) and reduces the risk of developing end-stage kidney disease (ESKD) in CKD patients. Nonetheless, a debate persists regarding the impact of RAS inhibitors on outcomes such as mortality and graft survival in renal transplant patients. To assess the effect of RAS inhibitors on graft recipients in the past decade, we conducted a systematic review and meta-analysis. Methods: We systematically searched Embase, PubMed, and the Cochrane Central Register of Clinical Trials on the internet from January 1, 2012, to August 1, 2022. We included 14 articles, comprising 5 randomized controlled trials and 9 cohort studies, including 45,377 patients. These studies compared patient or graft survival between an RAS inhibitors treatment arm and a control arm. Results: The meta-analysis revealed that RAS blockade was significantly associated with lower mortality (risk ratio [RR] = 0.68, 95% confidence interval [CI]: 0.58-0.81), reduced graft failure (RR = 0.63, 95% CI: 0.55-0.71), and significant changes in systolic blood pressure. Subgroup analysis of the groups of interest (interventions involving RAS blockade, follow-up period of ≥ 5 years) showed consistently reduced mortality (RR = 0.67, 95% CI: 0.56-0.81) and reduced graft loss (RR = 0.61, 95% CI: 0.54-0.70). Conclusions: Our meta-analysis demonstrated that RAS blockade application among renal transplant recipients significantly showed benefits on patient and allograft survival, especially for those with a follow-up period of ≥ 5 years.
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