Evidence map›Paper›PMID 31619367›Full record

ArticleMayo Clinic proceedings2019

Discontinuation of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Chronic Kidney Disease.

Yao Qiao, Jung-Im Shin, Yingying Sang, Lesley A Inker, Alex Secora, Shengyuan Luo, Josef Coresh, G Caleb Alexander, John W Jackson, Alex R Chang and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Mayo Clinic proceedings, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
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  6. Article
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  8. Review
  9. Discontinuing renin-angiotensin system inhibitors after incident hyperkalemia and clinical outcomes: target trial emulation.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
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  18. Heart Failure in Patients with Chronic Kidney Disease.Journal of clinical medicine · 2023
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Yao QiaoJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
Jung-Im ShinJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
Yingying SangJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
Lesley A InkerDepartment of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA.
Alex SecoraJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
Shengyuan LuoJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
Josef CoreshJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
G Caleb AlexanderJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
John W JacksonJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Alex R ChangDivision of Nephrology, Geisinger Health System, Danville, PA.
Morgan E GramsJohns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Internal Medicine, Division of Nephrology, Johns Hopkins University, Baltimore, MD. Electronic address: mgrams2@jhmi.edu.
Johns Hopkins University · USGeisinger Health System · USTufts Medical Center · US

Funding

Chronic Kidney Disease Prognosis Consortium (CKD-PC)R01DK100446 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, Morgan Erika Grams · 2014 to 2026
$10.7M
Medication Use and Adverse Events in CKDR01DK115534 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Alexander R Chang, Morgan Erika Grams · 2018 to 2026
$5.7M
The Comparative Effectiveness and Safety of Second-line Therapy in Patients with Type 2 DiabetesK01DK121825 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SHIN, JUNG-IM · 2019 to 2022
$615k
NIDDK NIH HHS K01 DK121825NIDDK NIH HHS R01 DK100446NIDDK NIH HHS R01 DK115534
6 · The paper itself

Abstract

objectiveTo assess the patterns of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACE-I/ARB) discontinuation in the setting of chronic kidney disease (CKD) progression in real-world clinical practice. PATIENTS AND

methodsWe identified incident ACE-I/ARB users with a baseline estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m

resultsAmong the 53,912 ACE-I/ARB users, the mean age was 59.9 years, and 50.6% were female. More than half of users discontinued ACE-I/ARB within 5 years of therapy initiation. The risk of ACE-I/ARB discontinuation increased with more advanced CKD stage. For example, patients who initiated ACE-I/ARB with CKD stage G4 (eGFR: 15-29 mL/min/1.73 m

conclusionIn a real-world cohort, discontinuation of ACE-I/ARB was common, particularly in patients with lower eGFR. Hyperkalemia, hypotension, low bicarbonate level, and hospitalization (AKI-related, in particular) were associated with a higher risk of ACE-I/ARB discontinuation. Additional studies are needed to evaluate the risk-benefit balance of discontinuing ACE-I/ARB in the setting of CKD progression.

Indexed as

Medication AdherenceAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDisease ProgressionFemaleGlomerular Filtration RateHumansMaleMiddle AgedRenal Insufficiency, ChronicRisk FactorsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonists

Identifiers

PMID31619367
PMCPMC6858794
OpenAlexW2980164571

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.