{"id":"1c021f5785d8","type":"article","url":"https://hartvaat.nl/2026/12/01/ras-remmers-verlagen-risico-op-nieuwe-ckd-bij-diabetes-type-2-met-behoudende-nie/","title":"RAS-remmers verlagen risico op nieuwe CKD bij diabetes type 2 met behoudende nierfunctie","title_en":"Prevention of new-onset chronic kidney disease with renin-angiotensin system blockers in type 2 diabetes with preserved kidney function.","category":"hypertensie","category_label":"Hypertensie","professions":["apotheker","huisarts","internist"],"tags":[],"journal":"Renal failure","doi":"10.1080/0886022X.2026.2711459","source_url":"https://doi.org/10.1080/0886022X.2026.2711459","authors":["Wan-Chia Hsu","Shih-Yuan Hung","Sheng-Hsiang Lin","Yuan-Yow Chiou","Yu-Ling Lin","Hsi-Hao Wang","Li-Chun Ho","Yi-Che Lee"],"significance":5,"published":"2026-08-17","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"In a multicenter retrospective cohort study of 3,316 patients with type 2 diabetes, newly diagnosed hypertension, and preserved kidney function, researchers evaluated the impact of ACE inhibitors or ARBs on the development of new-onset chronic kidney disease. RAS blocker therapy was associated with a significantly reduced risk of new-onset CKD (HR 0.72; 95% CI 0.60-0.86), with consistent results in competing-risk and time-dependent analyses. These findings support the early use of RAS blockade for renal protection in this population, even when baseline kidney function remains normal.","created":"2026-08-11T00:58:55Z","updated":"2026-08-11T00:58:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een multicenter retrospectieve cohortstudie onder 3.316 patiënten met type 2-diabetes en nieuw gediagnosticeerde hypertensie en een behoudende nierfunctie, werd het effect van ACE-remmers of ARBs geëvalueerd op het ontstaan van chronische nierziekte (CKD). Gebruik van RAS-remmers ging gepaard met een significant lager risico op nieuwe CKD (HR 0,72; 95% BI 0,60-0,86), een resultaat dat consistent bleef bij analyses met concurrerende risico's en tijd-afhankelijke blootstelling. Deze bevindingen ondersteunen het vroeg starten van RAS-remmers bij deze patiëntengroep voor nierbescherming, ook wanneer de nierfunctie nog intact is.","abstract_original":"Renin-angiotensin system (RAS) blockers, including angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are known to slow chronic kidney disease (CKD) progression in patients with established renal impairment. However, whether RAS blockade can prevent new-onset CKD in patients with type 2 diabetes and hypertension who maintain preserved kidney function remains unclear. We addressed this question in a multicenter retrospective cohort study. Beginning with 316,693 individuals with type 2 diabetes and newly diagnosed hypertension, we retained 3,316 ACEI/ARB users and 1,409 nonusers after generalized boosted model weighting to equalize baseline characteristics. Three renal endpoints were followed: a sustained eGFR below 60 mL/min/1.73 m2, incident albuminuria (urinary albumin-to-creatinine ratio of 30 mg/g or higher), and a composite of either. Associations between RAS blocker exposure and each endpoint were quantified using Cox proportional hazards regression, with competing-risk and time-dependent variants applied as confirmatory analyses. ACEI/ARB therapy was associated with a significantly lower risk of new-onset CKD (HR 0.72; 95% CI 0.60-0.86), with consistent findings after accounting for competing risks (HR 0.73; 95% CI 0.61-0.87) and time-dependent exposure (HR 0.81; 95% CI 0.68-0.96). These findings suggest that RAS blockade may confer early kidney protection in patients with type 2 diabetes and hypertension with preserved renal function."}