Loop diuretics are used to manage the hypertension and congestion often caused by chronic kidney disease (CKD), but they also activate the renin-angiotensin system, leading to potential cardiovascular and kidney damage. Renin-angiotensin system (RAS) inhibitors may help protect against this damage.
In a post hoc analysis published in Kidney360, Sunil Bhandari, MBChB, MRCP, PhD, MClinEd, and colleagues investigated the interaction between RAS inhibitors and loop diuretics among patients with advanced CKD. The study used data from the STOP-ACEi (angiotensin-converting enzyme inhibitor) trial, in which patients with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2 and progressive CKD were randomized to either stop or continue treatment with a RAS inhibitor.
The researchers compared outcomes between…