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- Publisher Website: 10.1186/s12916-021-01951-4
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- PMID: 33766008
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Article: Using Mendelian randomization study to assess the renal effects of antihypertensive drugs
Title | Using Mendelian randomization study to assess the renal effects of antihypertensive drugs |
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Authors | |
Keywords | Antihypertensives Kidney function Mendelian randomization |
Issue Date | 2021 |
Publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmed/ |
Citation | BMC Medicine, 2021, v. 19 n. 1, p. article no. 79 How to Cite? |
Abstract | Background:
Angiotensin-converting enzyme (ACE) inhibitors and/or in combination with calcium channel blockers (CCBs) are generally recommended as the first-line antihypertensive therapy for people with hypertension and kidney dysfunction. Evidence from large randomized controlled trials comprehensively comparing renal effects of different classes of antihypertensive drugs is lacking.
Methods:
We used a Mendelian randomization study to obtain unconfounded associations of genetic proxies for antihypertensives with kidney function. Specifically, we used published genetic variants in genes regulating target proteins of these drugs and then applied to a meta-analysis of the largest available genome-wide association studies of kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), and albuminuria). Inverse variance weighting was used as the main analysis and to combine estimates from different sources.
Results:
Genetically predicted ACE inhibition was associated with higher eGFR (effect size 0.06, 95% confidence interval (CI) 0.008, 0.11), while genetic proxies for beta-blockers were associated with lower eGFR (− 0.02, 95% CI − 0.04, − 0.004) when meta-analyzing the UK Biobank and CKDGen. Genetic proxies for CCBs were associated with lower UACR (− 0.15, 95% CI − 0.28, − 0.02) and lower risk of albuminuria (odds ratio 0.58, 95% CI 0.37, 0.90) in CKDGen. The associations were robust to using different analysis methods and different genetic instruments.
Conclusions:
Our findings suggest the reno-protective associations of genetically proxied ACE inhibitors and CCBs, while genetic proxies for beta-blockers may be related to lower eGFR. Understanding the underlying mechanisms would be valuable, with implications for drug development and repositioning of treatments for kidney disease. |
Persistent Identifier | http://hdl.handle.net/10722/305702 |
ISSN | 2023 Impact Factor: 7.0 2023 SCImago Journal Rankings: 2.711 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Zhao, J | - |
dc.contributor.author | Schooling, CM | - |
dc.date.accessioned | 2021-10-20T10:13:06Z | - |
dc.date.available | 2021-10-20T10:13:06Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | BMC Medicine, 2021, v. 19 n. 1, p. article no. 79 | - |
dc.identifier.issn | 1741-7015 | - |
dc.identifier.uri | http://hdl.handle.net/10722/305702 | - |
dc.description.abstract | Background: Angiotensin-converting enzyme (ACE) inhibitors and/or in combination with calcium channel blockers (CCBs) are generally recommended as the first-line antihypertensive therapy for people with hypertension and kidney dysfunction. Evidence from large randomized controlled trials comprehensively comparing renal effects of different classes of antihypertensive drugs is lacking. Methods: We used a Mendelian randomization study to obtain unconfounded associations of genetic proxies for antihypertensives with kidney function. Specifically, we used published genetic variants in genes regulating target proteins of these drugs and then applied to a meta-analysis of the largest available genome-wide association studies of kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), and albuminuria). Inverse variance weighting was used as the main analysis and to combine estimates from different sources. Results: Genetically predicted ACE inhibition was associated with higher eGFR (effect size 0.06, 95% confidence interval (CI) 0.008, 0.11), while genetic proxies for beta-blockers were associated with lower eGFR (− 0.02, 95% CI − 0.04, − 0.004) when meta-analyzing the UK Biobank and CKDGen. Genetic proxies for CCBs were associated with lower UACR (− 0.15, 95% CI − 0.28, − 0.02) and lower risk of albuminuria (odds ratio 0.58, 95% CI 0.37, 0.90) in CKDGen. The associations were robust to using different analysis methods and different genetic instruments. Conclusions: Our findings suggest the reno-protective associations of genetically proxied ACE inhibitors and CCBs, while genetic proxies for beta-blockers may be related to lower eGFR. Understanding the underlying mechanisms would be valuable, with implications for drug development and repositioning of treatments for kidney disease. | - |
dc.language | eng | - |
dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmed/ | - |
dc.relation.ispartof | BMC Medicine | - |
dc.rights | BMC Medicine. Copyright © BioMed Central Ltd. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Antihypertensives | - |
dc.subject | Kidney function | - |
dc.subject | Mendelian randomization | - |
dc.title | Using Mendelian randomization study to assess the renal effects of antihypertensive drugs | - |
dc.type | Article | - |
dc.identifier.email | Zhao, J: janezhao@hku.hk | - |
dc.identifier.email | Schooling, CM: cms1@hkucc.hku.hk | - |
dc.identifier.authority | Zhao, J=rp02336 | - |
dc.identifier.authority | Schooling, CM=rp00504 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1186/s12916-021-01951-4 | - |
dc.identifier.pmid | 33766008 | - |
dc.identifier.pmcid | PMC7995783 | - |
dc.identifier.scopus | eid_2-s2.0-85103402815 | - |
dc.identifier.hkuros | 328034 | - |
dc.identifier.volume | 19 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | article no. 79 | - |
dc.identifier.epage | article no. 79 | - |
dc.identifier.isi | WOS:000632910500001 | - |
dc.publisher.place | United Kingdom | - |