April 29, 2011

Reducing Risk of Kidney Failure

(Ivanhoe Newswire) --A drug used to treat high blood pressure may reduce the risk of kidney failure in obese patients. Research studies have found that an obese person is nearly seven-times more likely to develop kidney failure than a normal-weight person. An angiotensin-converting enzyme (ACE) inhibitor drug, known as ramipril, has proven to be effective in lowering the risk of end-stage renal disease (ESRD) in these patients.

For the study, researchers analyzed data from another trial that compared ramipril with an inactive placebo in more than 300 patients with non-diabetes-related chronic kidney disease. Researchers compared rates of progression to ESRD for obese and overweight patients versus normal-weight patients. The researchers found the risk of developing ESRD was more than twice as high for obese patients compared to normal-weight patients who took the placebo. For patients who were overweight but not obese, the risk of ESRD was similar to that in normal-weight patients. On the other hand, ramipril reduced the risk of progression to ESRD in all three weight groups. The risk reduction was much greater for obese patients: 86 percent compared to 45 percent in normal-weight patients. Obese patients taking ramipril had about the same ESRD risk as normal-weight patients.

"Obese patients with kidney disease progress more quickly towards renal failure compared to non-obese patients, and ramipril virtually abolishes this excess risk," Carmine Zoccali, M.D., CNR-IBIM and Ospedali Riuniti di Reggio Calabria, Italy, was quoted as saying.

Since the study analyzed data from a previous clinical trial, it cannot be considered as definitive proof that ACE inhibitors have any noteworthy impact in obese patients with chronic kidney disease. In addition, the study focused on kidney disease associated with high levels of protein in the urine. It's unclear whether ACE inhibitors will have the same effect in patients with lower levels of protein in their urine. Also, since the patients were all white Europeans, researchers say future studies will need to include other ethnicities.

SOURCE: Journal of the American Society of Nephrology (JASN), April 28, 2011