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2017 ; 7
(ä): 46518
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Renin-Angiotensin System Inhibitor is Associated with Lower Risk of Ensuing
Chronic Kidney Disease after Functional Recovery from Acute Kidney Injury
#MMPMID28406186
Chou YH
; Huang TM
; Pan SY
; Chang CH
; Lai CF
; Wu VC
; Wu MS
; Wu KD
; Chu TS
; Lin SL
Sci Rep
2017[Apr]; 7
(ä): 46518
PMID28406186
show ga
Acute kidney injury (AKI) is an independent risk factor for ensuing chronic
kidney disease (CKD). Animal studies have demonstrated that renin-angiotensin
system (RAS) inhibitor can reduce ensuing CKD after functional recovery from AKI.
Here we study the association between ensuing CKD and use of RAS inhibitor
including angiotensin converting enzyme inhibitor or angiotensin II type 1a
receptor blocker starting after renal functional recovery in our prospectively
collected observational AKI cohort. Adult patients who had cardiac
surgery-associated AKI (CSA-AKI) are studied. Patients with CKD, unrecovered AKI,
and use of RAS inhibitor before surgery are excluded. Among 587 eligible
patients, 94 patients are users of RAS inhibitor which is started and continued
after complete renal recovery during median follow-up period of 2.99 years. The
users of RAS inhibitor show significantly lower rate of ensuing CKD (users vs.
non-users, 26.6% vs. 42.2%) and longer median CKD-free survival time (users vs.
non-users, 1079 days vs. 520 days). Multivariate Cox regression analyses further
demonstrate that use of RAS inhibitor is independently associated with lower risk
of ensuing CKD (hazard ratio?=?0.46, P?0.001). We conclude that use of RAS
inhibitor in CSA-AKI patients after renal functional recovery is associated with
lower risk of ensuing CKD development.