Episode 331: 329. Should We Give AceI or ARBs to Patients with CKD 4 and 5?

Episode 331: 329. Should We Give AceI or ARBs to Patients with CKD 4 and 5?

https://www.acpjournals.org/doi/10.7326/M23-3236

Angiotensin-converting–enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) seldom are initiated among patients with chronic kidney disease (CKD) stage 4 or 5, despite guideline recommendations for these agents--- 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines - ScienceDirect

In adults with hypertension and CKD (stage 3 or higher or stage 1 or 2 with albuminuria [≥300 mg/d, or ≥300 mg/g albumin-to-creatinine ratio or the equivalent in the first morning void]), treatment with an ACE inhibitor is reasonable to slow kidney disease progression

Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers for Advanced Chronic Kidney Disease: A Systematic Review and Retrospective Individual Participant–Level Meta-analysis of Clinical Trials: Annals of Internal Medicine: Vol 177, No 7 (acpjournals.org)

In a patient-level meta-analysis of 18 randomized trials, researchers identified 1700 patients with stage 4 or 5 CKD to determine if initiating ACE inhibitors or ARBs affected progression to dialysis or death. follow-up ≈3 years.

Patients with CKD stage 4 or 5 (mean eGFR, 22 mL/minute/1.73 m2) who initiated ACE inhibitors or ARBs (vs. placebo or other antihypertensive agents) were less likely to progress to dialysis (12% vs. 17% annually; number needed to treat, 20), mortality was similar (≈3% annually).

Jaksot(385)

Episode 415: 422. Finerenone restores fertility?

Episode 415: 422. Finerenone restores fertility?

Lin Z, et al. Antifibrotic drug finerenone restores fertility in premature ovarian insufficiency. Science 2026 Feb 5; 391:eadz4075. DOI: 10.1126/science.adz4075. Premature ovarian insufficiency is usu...

2 Maalis 6min

Episode 414: 421. Scabies and DUKE criteria

Episode 414: 421. Scabies and DUKE criteria

Stavropoulou E, et al. Reassessing the 2023 International Society for Cardiovascular Infectious Diseases Duke clinical criteria for infective endocarditis: Impact of excluding fever and updating diagn...

25 Helmi 11min

Episode 413: 420. Frail and CODE LVO PLUS antibiotics don't help viral illness

Episode 413: 420. Frail and CODE LVO PLUS antibiotics don't help viral illness

we look at CODE LVO and what does being frail even mean?????vaccines may not help baby and antibiotics still don't help viral illness

5 Helmi 19min

Episode 412: CME song --Check the Lytes

Episode 412: CME song --Check the Lytes

CME song --Check the Lytes

20 Tammi 3min

Episode 411: CME - sodium, potassium, calcium

Episode 411: CME - sodium, potassium, calcium

CME - sodium, potassium, calcium

20 Tammi 43min

Episode 410: 418.  Beta Blockers Post MI, PSA, Youtube,

Episode 410: 418. Beta Blockers Post MI, PSA, Youtube,

10.1016/j.jaip.2025.07.005.40675327All of the videos were found to be useful or very useful, 99% were of moderate or high reliability, and 99% had moderate to excellent educational quality  Prostate-s...

15 Joulu 202540min

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://...

3 Joulu 202534min

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction - https://www.nejm.org/doi/full/10.1056/NEJMoa2504735?query=WB  McGuire DK et al. Oral semaglutide and cardiovascular outcom...

17 Marras 202522min

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