Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study

Chronic kidney disease (CKD) is associated with dementia. Angiotensin receptor blockers (ARBs) have been widely used for delaying CKD progression; however, their effect on dementia prevention in patients with CKD remains unclear. We designed a retrospective cohort study to investigate the effects of...

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Autores principales:	Yi-Hsien Chen, Yun-Yi Chen, Yu-Wei Fang, Ming-Hsien Tsai
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic kidney disease National Health Insurance Research Database angiotensin receptor blockers dementia Medicine R
Acceso en línea:	https://doaj.org/article/306648cec4dd4d6d94a6f30a29b43bf1
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spelling	oai:doaj.org-article:306648cec4dd4d6d94a6f30a29b43bf12021-11-11T17:47:13ZProtective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study10.3390/jcm102151752077-0383https://doaj.org/article/306648cec4dd4d6d94a6f30a29b43bf12021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5175https://doaj.org/toc/2077-0383Chronic kidney disease (CKD) is associated with dementia. Angiotensin receptor blockers (ARBs) have been widely used for delaying CKD progression; however, their effect on dementia prevention in patients with CKD remains unclear. We designed a retrospective cohort study to investigate the effects of ARBs on the incidence of dementia in patients with CKD. We selected 21,208 patients from the Taiwan nationwide database from 1 January 2006 to 31 December 2006. We identified ARB users (<i>n</i> = 17,466) and ARB non-users (<i>n</i> = 3742) and their medication possession ratio (MPR). The Cox proportional hazard model was used to estimate hazard ratios (HRs) for the incidence of dementia in ARB users in the CKD population. During the 11-year follow-up period, 2207 dementia events were recorded; multivariate-adjusted hazard ratios for dementia by ARB usage and ARB usage per MPR were 0.578 (95% CI: 0.52–0.643) and 0.996 (95% CI: 0.995–0.998), respectively. This association was observed in almost all subgroups. Dose frequency effect of ARBs was noted; patients with higher MPRs of ARBs generally had higher protection from dementia. Patients with hypertension and CKD who received ARBs had a decreased risk of dementia. Protective effects of ARBs on dementia increased with the frequency of ARB use.Yi-Hsien ChenYun-Yi ChenYu-Wei FangMing-Hsien TsaiMDPI AGarticlechronic kidney diseaseNational Health Insurance Research Databaseangiotensin receptor blockersdementiaMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5175, p 5175 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic kidney disease National Health Insurance Research Database angiotensin receptor blockers dementia Medicine R
spellingShingle	chronic kidney disease National Health Insurance Research Database angiotensin receptor blockers dementia Medicine R Yi-Hsien Chen Yun-Yi Chen Yu-Wei Fang Ming-Hsien Tsai Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
description	Chronic kidney disease (CKD) is associated with dementia. Angiotensin receptor blockers (ARBs) have been widely used for delaying CKD progression; however, their effect on dementia prevention in patients with CKD remains unclear. We designed a retrospective cohort study to investigate the effects of ARBs on the incidence of dementia in patients with CKD. We selected 21,208 patients from the Taiwan nationwide database from 1 January 2006 to 31 December 2006. We identified ARB users (<i>n</i> = 17,466) and ARB non-users (<i>n</i> = 3742) and their medication possession ratio (MPR). The Cox proportional hazard model was used to estimate hazard ratios (HRs) for the incidence of dementia in ARB users in the CKD population. During the 11-year follow-up period, 2207 dementia events were recorded; multivariate-adjusted hazard ratios for dementia by ARB usage and ARB usage per MPR were 0.578 (95% CI: 0.52–0.643) and 0.996 (95% CI: 0.995–0.998), respectively. This association was observed in almost all subgroups. Dose frequency effect of ARBs was noted; patients with higher MPRs of ARBs generally had higher protection from dementia. Patients with hypertension and CKD who received ARBs had a decreased risk of dementia. Protective effects of ARBs on dementia increased with the frequency of ARB use.
format	article
author	Yi-Hsien Chen Yun-Yi Chen Yu-Wei Fang Ming-Hsien Tsai
author_facet	Yi-Hsien Chen Yun-Yi Chen Yu-Wei Fang Ming-Hsien Tsai
author_sort	Yi-Hsien Chen
title	Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
title_short	Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
title_full	Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
title_fullStr	Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
title_full_unstemmed	Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study
title_sort	protective effects of angiotensin receptor blockers on the incidence of dementia in patients with chronic kidney disease: a population-based nationwide study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/306648cec4dd4d6d94a6f30a29b43bf1
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Protective Effects of Angiotensin Receptor Blockers on the Incidence of Dementia in Patients with Chronic Kidney Disease: A Population-Based Nationwide Study

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