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Heart Medications Easily Removed through Dialysis May Increase Risk of Premature Death

Nov 4, 2014

Dialysis patients who take heart medications that are easily removed from the bloodstream through dialysis may be at increased risk of premature death compared to patients whose heart medications are more difficult to remove.

The findings come from a study that appeared online last week in the Journal of the American Society of Nephrology (JASN), reports. The drugs studied – beta blockers – are prescribed to control hearth rhythm, treat angina, and reduce high blood pressure. They lower the risk of premature death for people with heart disease. Beta blockers differ in the extent to which they are filtered out through hemodialysis. If dialysis removes the drug from the bloodstream, the patient cannot experience its full benefit.

Dr. Matthew Weir of Western University, in Ontario, Canada, along with colleagues, analyzed health information from Canadian patients, comparing those taking a beta blocker that is easily removed by dialysis to those whose beta blocker is not easily filtered out by dialysis, MedicalXpress reports. The high dialyzability group included 3,294 dialysis patients taking atenolol, acebutolol, or metoprolol. The low dialyzability group had 3,294 dialysis patients taking bisoprolol or propranolol. The high dialyzability group had a 1.4-increased risk of dying within 180 days. The researchers also analyzed more than 27,000 patients taking beta blockers who were not receiving dialysis and found no difference between the two medication groups in rate of premature death. This suggests that dialysis played an important part in the relationship between bisoprolol/propranolol beta blockers and lower risk of premature death.

"Although we can't draw causal relationships from our observational study,” Dr. Weir said, “we did see the relationship that we hypothesized: the risk of death was higher in patients whose beta blocker was readily removed from their circulation by hemodialysis.” Changing to a difficult-to-remove drug might be a simple way to lower the risk of premature death for people on dialysis who take a beta blocker.

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