title: Management of renin-angiotensin system blockade in patients with chronic kidney disease under specialist care. Retrospective cross-sectional study.
abstract: BACKGROUND
  Reduction of blood pressure and proteinuria by blockade of the renin-angiotensin-aldosterone system (RAAS) has been the cornerstone of renoprotective intervention for patients with chronic kidney disease (CKD) for many years.
  
  
  OBJECTIVE
  The aims were to check the use of angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor blockers (ARBs) in CKD patients.
  
  
  METHODS
  This was a retrospective, cross-sectional study analysing data from medical records of patients who received specialist care in 1996, 2001, 2006, 2011 in the Outpatient Unit.
  
  
  RESULTS
  The numbers of CKD subjects included in the four independent surveys were as follows: 190, 490, 1799, 1696. The usage of RAAS blocking agents overall increased significantly in subsequent years as follows: 25, 49, 63, 74%. Patients with proteinuria and cardiovascular complications and/or diabetes were receiving RAAS blocking agents more commonly than others. The use of ACEI and/ or ARB in stage 4-5 CKD increased in subsequent years. In 2011 dual RAAS blockade was used in 10% CKD patients overall and 19% patients presented proteinuria.
  
  
  CONCLUSIONS
  The use of RAAS blocking agents were increasing in CKD patients under specialist care between 1996-2011. The quality of the management was gradually improved.
authors.affiliation: Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, Poland leszek.tylicki@gumed.edu.pl.
authors.forename: Leszek
authors.initials: L
authors.lastname: Tylicki
authors.affiliation: NZOZ Diaverum Dialysis Center Gdynia, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jakubowska
authors.affiliation: Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Lizakowski
authors.affiliation: Interfaculty College of Medical Informatics and Biostatistics, Medical University of Gdansk, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Świetlik
authors.affiliation: Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, Poland.
authors.forename: Bolesław
authors.initials: B
authors.lastname: Rutkowski
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D019090:Case Management; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011507:Proteinuria / Q000188:drug therapy; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012189:Retrospective Studies
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D011188:Potassium
keywords: Renin-angiotensin system; blockade; chronic kidney disease; hypertension; management