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Impact of angiotensin-converting enzyme inhibitors or receptor blockers on post-ICU discharge outcome in patients with acute kidney injury
- Source :
- Intensive Care Medicine, Intensive Care Medicine, Springer Verlag, 2018, 44 (5), pp.598-605. ⟨10.1007/s00134-018-5160-6⟩
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- International audience; Purpose: Acute kidney injury (AKI) is associated with the activation of the renin–angiotensin system. Whether angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB) improve outcome in patients recovering from AKI remains unexplored. The purpose was to investigate the association between prescription of ACEi/ARB at intensive care unit (ICU) discharge and 1-year outcome in patients recovering from AKI.Methods: Association between ACEi/ARB and 1-year mortality rate was explored in 1551 patients discharged from 21 European ICUs in an observational cohort. One-year all-cause mortality after ICU discharge was the primary endpoint. AKI was defined using the kidney disease improvement global outcome definition. Propensity score matching was used to consider the probability to receive ACEi/ARB at ICU discharge and included chronic heart failure, ACEi/ARB on ICU admission, Charlson Comorbidity Index, age, diabetes mellitus, chronic kidney disease, estimated glomerular filtration rate and arterial blood pressure at ICU discharge vasopressors and renal replacement therapy.Results: Overall, 1-year mortality was 28 and 15% in patients with AKI (n = 611, 39%) and without AKI (n = 940), respectively. In patients with AKI, unadjusted, adjusted and propensity-score matched 1-year mortality rates were lower in patients treated with ACEi/ARB at ICU discharge [HR of 0.55 (0.35–0.89), HR of 0.45 (0.27–0.75), and HR of 0.48 (0.27–0.85, p
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
030232 urology & nephrology
Renal function
030204 cardiovascular system & hematology
urologic and male genital diseases
Critical Care and Intensive Care Medicine
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
law.invention
03 medical and health sciences
0302 clinical medicine
law
Internal medicine
Angiotensin-converting enzyme inhibitors
medicine
cardiovascular diseases
Renal replacement therapy
Mortality
business.industry
ICU discharge
Mortality rate
Acute kidney injury
Angiotensin-receptor blockers
medicine.disease
Intensive care unit
female genital diseases and pregnancy complications
3. Good health
Blood pressure
Heart failure
ICU
[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
Critically Ill
business
Kidney disease
Subjects
Details
- ISSN :
- 14321238 and 03424642
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Intensive Care Medicine
- Accession number :
- edsair.doi.dedup.....16df470a0fd6b61eebff2ab27114871e