Zhang C, Duan ZY, Nie SS, Zhang Z, Guo XR, Zhang CY, Dong J, Cai GY. Renin-angiotensin system inhibitors prescriptions in Chinese hospitalized chronic kidney disease patients. World J Clin Cases 2024; 12(17): 3061-3075 [PMID: 38898860 DOI: 10.12998/wjcc.v12.i17.3061]
Corresponding Author of This Article
Guang-Yan Cai, PhD, Chief Physician, Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. vinxiong66@163.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2024; 12(17): 3061-3075 Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.3061
Renin-angiotensin system inhibitors prescriptions in Chinese hospitalized chronic kidney disease patients
Chun Zhang, Zhi-Yu Duan, Sa-Sa Nie, Zhou Zhang, Xin-Ru Guo, Chao-Yang Zhang, Jing Dong, Guang-Yan Cai
Chun Zhang, Zhi-Yu Duan, Sa-Sa Nie, Zhou Zhang, Chao-Yang Zhang, Guang-Yan Cai, Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
Xin-Ru Guo, School of Medicine, Nankai University, Tianjin 300071, China
Jing Dong, National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Cai GY designed the study; Zhang C, Duan ZY, Nie SS, Zhang Z, Guo XR, Zhang CY, Dong J performed the data collection and analysed the data; and Zhang C wrote the manuscript. All authors reviewed the manuscript.
Institutional review board statement: This study was approved by Ethics Committee of Chinese PLA General Hospital, Approval No. S2023-566-01.
Informed consent statement: The informed consent was waived by the ethics committee of The First Medical Centre, Chinese PLA General Hospital.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: Data should be obtained by contacting the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guang-Yan Cai, PhD, Chief Physician, Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. vinxiong66@163.com
Received: March 9, 2024 Revised: April 23, 2024 Accepted: April 29, 2024 Published online: June 16, 2024 Processing time: 87 Days and 4.5 Hours
Abstract
BACKGROUND
Many guidelines have recommended renin-angiotensin system inhibitors (RASI) as the first-line treatment for patients with chronic kidney disease (CKD). We studied RASI prescription trends from 2010 to 2019, and analyzed the characteristics associated with RASI prescription in Chinese hospitalized CKD patients.
AIM
To study the prescription of renin angiotensin system inhibitors in hospitalized patients with CKD in China.
METHODS
It was retrospectively, cross-sectional reviewed RASI prescriptions in hospitalized CKD patients in China from 2010 to 2019. RASI prescribing trends were analyzed from 2010 to 2019, and bivariate and multivariate logistic regression analyses were conducted to identify characteristics associated with RASI prescription.
RESULTS
A total of 35090 CKD patients were included, with 10043 (28.6%) RASI prescriptions. Among these patients, 18919 (53.9%) met the criteria for RASI treatments based on the 2012 kidney disease: Improving global outcomes guidelines. Of these, 7246 (38.3%) patients received RASI prescriptions. RASI prescriptions showed an initial rapid increase from 2011 to 2012, reached its peak around 2015 and 2016, and then exhibited a subsequent slight decreasing trend. Both bivariate and multivariate analyses showed that several characteristics, including the male gender, age less than 60-year-old, nephrology department admission, lower CKD stage, history of hypertension or diabetes, proteinuria, glomerulonephritis as the CKD etiology, and non-acute kidney injury were associated with RASI prescriptions.
CONCLUSION
The frequency of RASI prescriptions showed an initial increase but a slight decreasing trend in more recent years. CKD patients with certain characteristics such as elderly age, advanced disease stage, surgery department admission, or acute kidney injury were less likely to receive RASI prescriptions. In the application of RASI in hospitalized CKD patients is insufficient. The actual clinical practice needs to be improved. The development of related research is helpful to guide the correct choice of clinical treatment strategy.
Core Tip: This study examines the prescribing trends of renin-angiotensin system inhibitors (RASI) in hospitalized Chinese chronic kidney disease (CKD) patients from 2010 to 2019. Despite guidelines recommending RASI as first-line therapy, findings reveal a peak in prescriptions around 2015 and 2016, followed by a slight decline. Factors such as younger age, male gender, and non-acute conditions increased RASI prescription likelihood. The research highlights a need for improved adherence to clinical guidelines in RASI application to enhance CKD patient care outcomes.
