Pleiotropic effects of angiotensin II blockers in hemodialysis patients: myth or reality?

Mechanistic studies suggest that angiotensin II receptor blockers (ARBs) may have pleiotropic effects on the cardiovascular system in hemodialysis patients. A new randomized trial by Peters et al. failed to show a benefit of irbesartan on biomarkers of arterial stiffness, left ventricular mass, and autonomic nerve function. Their findings suggest that, like in the general population and other disease states, in hemodialysis patients the type of antihypertensive drug is unlikely to be of major clinical relevance.