Renin-angiotensin system inhibitors initiation and mortality in non-proteinuric chronic kidney disease: a target trial emulation

Clicks: 9
ID: 337549
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #212 of 228 articles by views in clinical kidney journal

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 228 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Treatment options for nonproteinuric chronic kidney disease (CKD) are limited. While renin-angiotensin system inhibitors (RASIs) are cornerstone therapies for proteinuric CKD, evidence supporting the clinical benefit of RASIs initiation in nonproteinuric CKD is lacking. Methods We emulated sequential target trials using a retrospective cohort from the China Renal Data System (CRDS). Adults with nonproteinuric CKD (urine albumin-to-creatinine ratio <30 mg/g) were included to assess the intention-to-treat effect of initiating RASIs on all-cause and cardiovascular mortality. The primary estimate was the three-year risk difference. A composite kidney outcome (>25% eGFR decline with stage deterioration or kidney replacement therapy) was also explored. Results A total of 17 382 eligible person-trials (10 101 unique persons) were included. The three-year cumulative incidence of all-cause mortality was 14.88% (95% confidence interval [CI], 13.65% to 16.51%) and 18.26% (95% CI, 17.67% to 19.42%) in the RASIs initiation group and the control group, respectively, corresponding to a risk difference of − 3.39% (95% CI, −4.71% to − 2.07%). A significant association favoring RASIs initiation was also observed in terms of cardiovascular mortality, with a three-year risk difference of -1.46% (95%CI, -2.57% to -0.52%). Estimates from the subgroup and the sensitivity analyses were consistent with the primary analysis. A similar trend of association was observed for composite kidney outcomes, though the three-year cumulative risk difference between groups did not reach statistical significance (risk difference, −0.88%; 95% CI, −2.42% to 1.40%). Conclusions Initiation of RASIs may be associated with lower risks of all-cause and cardiovascular mortality in patients with nonproteinuric CKD.
Reference Key
openalex_W7224109537 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fan Luo, Luhua Jin, Shiyu Zhou, Ruixuan Chen, Mingzhen Pang, Yuxin Lin, Yanqin Li, Licong Su, Xin Ping Xu, Sheng Nie, Fan Fan Hou
Are you one of these authors? Claim your profile
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag285
URL
https://doi.org/10.1093/ckj/sfag285
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.