ホシノ　ジユンイチ   Hoshino Jiyun'ichi   星野　純一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Prescription of renin-angiotensin-aldosterone system inhibitors (RAASi) and its determinants in patients with advanced CKD under nephrologist care.
掲載誌名	正式名：Journal of clinical hypertension (Greenwich, Conn.) 略　 称：J Clin Hypertens (Greenwich) ISSNコード：17517176/15246175
掲載区分	国外
巻・号・頁	21(7),pp.991-1001
著者・共著者	Pecoits-Filho Roberto, Fliser Danilo, Tu Charlotte, Zee Jarcy, Bieber Brian, Wong Michelle M Y, Port Friedrich, Combe Christian, Lopes Antonio A, Reichel Helmut, Narita Ichiei, Stengel Benedicte, Robinson Bruce M, Massy Ziad,
発行年月	2019/09
概要	Renin-angiotensin-aldosterone system inhibitors (RAASi) are recommended for chronic kidney disease (CKD) patients. In this study, we describe RAASi prescription patterns in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) in Brazil, Germany, France, and the United States (US). 5870 patients (mean age 66-72 years; congestive heart failure [CHF] in 11%-19%; diabetes in 43%-54%; serum potassium ≥5 in 20%-35%) were included. RAASi prescription was more common in Germany (80%) and France (77%) than Brazil (66%) and the United States (52%), where the prevalence of prescription decreases particularly in patients with CKD stage 5. In the multivariable regression model, RAASi prescription was least common in the United States and more common in patients who were younger, had diabetes, hypertension, or less advanced CKD. In conclusion, RAASi prescription patterns vary by country, and by demographic and clinical characteristics. RAASi appear to be underused, even among patients with strong class-specific recommendations. Although the reasons for this variation could not be fully identified in this cross-sectional observation, our data indicate that the risk of hyperkalemia may contribute to the underuse of this class of agents in moderate to advanced CKD.
DOI	10.1111/jch.13563
PMID	31169352