AI Snips
Chapters
Transcript
Episode notes
Early Signals Were Misleading
- Early observational reports that stopping RAS inhibitors recovered GFR were likely biased and underpowered.
- Laurie Tomlinson found confounding drove much of the early alarm about ACEi/ARB harm in AKI-era observations.
Select Progressors For Power
- Enroll progressive CKD patients (eGFR <30 and decline >2 mL/min/1.73m2/yr) to get meaningful event rates.
- Avoid recruiting stable GFR patients who dilute trial power and outcomes.
Pragmatic Trial Design Matters
- STOP-ACE randomized continuation versus discontinuation pragmatically with open-label management and variable dosing.
- The trial prioritized real-world practice over tight protocolized drug control.