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Abstract: Objective: To evaluate the association between angiotensin-converting enzyme inhibitors
(ACEIs) and angiotensin receptor blockers (ARBs) use prior to a septic shock episode and the
development, prognosis and long-term recovery from acute kidney injury (AKI).
Design: A single-centre, prospective observational study was carried out between September
2005 and August 2010.
Scope: Patients admitted to the ICU of a third level hospital.
Patients: A total of 386 septic shock patients were studied.
Variables of interest: Use of ACEIs/ARBs, AKI development, recovery of previous creatinine
levels and time to recovery.
Results: A total of 386 patients were included, of which 312 (80.8%) developed AKI during ICU
stay and 23% were receiving ACEIs/ARBs. The percentage of patients on ACEIs/ARBs increased
significantly in relation to more severe stages of AKI irrespective of the kind of AKI score.
After adjusting for confounders, the development of AKI was independently associated to the
use of ACEIs/ARBs (OR 2.19; 95%CI 1.21---3.84; p = .04). With respect to the recovery of kidney
function, the group of patients on ACEIs/ARBs had significantly higher creatinine levels at ICU
discharge and needed hemodialysis more frequently thereafter. However, use of ACEIs/ARBs
affected neither recovery of previous creatinine levels nor significantly delayed recovery.
Fuente: Med Intensiva. 2017; 41(1): 21-27
Editorial: Ediciones Doyma, S.L.
Año de publicación: 2017
Nº de páginas: 7
Tipo de publicación: Artículo de Revista
BORJA SUBERVIOLA CAÑAS
EMILIO RODRIGO CALABIA
ALEJANDRO GONZALEZ CASTRO
MARIA MILAGROS HERAS VICARIO
ALVARO CASTELLANOS ORTEGA