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논문분류	춘계학술대회 초록집
제목	The Association of RAAS Blockade and the Progression of Residual Kindey Function Decline: A Nation-wide Prospective Cohort Study
저자	Kyung don YOO1, Clara KIM2, Yun kyu OH3, Shin-wook KANG4, Chul woo YANG5, Yong-lim KIM6, Yon su KIM7, Chun soo LIM3, *Jung pyo LEE3
출판정보	2017; 2017(1):
키워드	Hemodialysis; residual renal function; RAAS blockade
초록	Objectives : Our aim was to evaluate the clinical effects of renin angiotensin aldosterone system (RAAS) blockade on residual renal function(RRF) in newly diagnosed patients with end-stage renal disease (ESRD) undergoing hemodialysis in Korea. Methods : A total of 920 patients were enrolled in the Clinical Research Center for ESRD prospective observation cohort. RAAS treatment was defined as the used of angiotensin converting enzyme inhibitor or angiotensin receptor blocker for >3 months. RRF were defined using 24-hour urine volume and Creatinie Clearance, measured at 3 and 12 months after dialysis initiation. Effects of RAAS blockade on RRF were evaluated using logistic regression. Results : There were 269 incident dialysis patients were completely measured RRF at three and twelve month after dialysis initiation. The 145 patients (54%) were in the RAAS group. The RAAS and control groups were comparable in terms of age, sex, primary renal disease, comorbidities, and dialysis dose including Kt/V, ultrafiltration volume per session. The RRF in both group decreased over a 12-month period. However, the decline of RRF between two groups were not statistically significant after adjustment for RRF at 3month (ANCOVA analysis). The development of anuria (24hr urine volume < 100ml) at 12 months was similar in both groups (39.3% vs. 41.1%, RAAS group vs. control group). On the logistic regression analysis, RAAS did not provide a protective effect on RRF preservation after adjustment for age, sex, diabetes history, blood pressure and ultrafiltration volume ( Odds ratio 1.27 95% CI 0.72-2.26, p=0.404). Conclusions : In Korean patients with ESRD, RAAS blockade failed to clarify the protective effect for RRF. Further research needed to provide optimal treatment for preservation of RRF, especially in Korean patients with incident dialysis.
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