RT Journal
A1 Onuigbo M, Onuigbo N
T1 PRedialysis nephrology care of older patients approaching end-stage renal disease
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD December 12
VO 171
IS 22
SP 2066
OP 2066
DO 10.1001/archinternmed.2011.586
UL http://dx.doi.org/10.1001/archinternmed.2011.586
AB 
We agree with the authors that their findings have raised very poignant questions and doubts regarding the efficacy of several costly interventions possibly provided more by nephrologists, including aggressive blood pressure lowering.1 The recent, very disappointing results of the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET) with combination angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy is a strong reminder of the potential pitfalls of such a strategy. Similar arguments could indeed be made against the comparably unproven benefits of overuse of erythropoiesis-stimulating agents and revascularization for atherosclerotic renovascular disease, modalities that are also more likely to be provided by nephrologists vs internists.1