Academic Journal
Association between peri-operative angiotensin-converting enzyme inhibitors and angiotensin-2 receptor blockers and acute kidney injury in major elective non-cardiac surgery: a multicentre, prospective cohort study
| العنوان: | Association between peri-operative angiotensin-converting enzyme inhibitors and angiotensin-2 receptor blockers and acute kidney injury in major elective non-cardiac surgery: a multicentre, prospective cohort study |
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| المؤلفون: | Drake, TM, Cheung, LK, Gaba, F, Glasbey, J, Griffiths, N, Helliwell, RJ, Huq, T, Khaw, R, Mayes, J, Khan, S, Rafiq, N, Woin, E, Fitzgerald, JE, Harrison, EM, Nepogodiev, D, Bath, M, Borakati, A, Burke, J, Claireaux, H, Deekonda, P, Gundogan, B, Joyce, H, Kamarajah, S, Khatri, C, Kong, C, McLean, KA, Mcnamee, L, Mohan, M, Bhangu, A, Arulkumaran, N, Bell, S, Duthie, F, Hughes, J, Prowle, J, Richards, T, Dynes, K, Patel, P, Wigley, C, Suresh, R, Shaw, A, Klimach, S, Jull, P, Evans, D, Preece, R, Ibrahim, I, Manikavasagar, V, Brown, FS, Teo, R, Sim, DPY, Logan, AE, Barai, I, Amin, H, Suresh, S, Sethi, R, Bolton, W, Corbridge, O, Horne, L, Attalla, M, Morley, R, Hoskins, T, McAllister, R, Lee, S, Dennis, Y, Nixon, G, Heywood, E, Wilson, H, Ng, L, Samaraweera, S, Mills, A, Doherty, C, Belchos, J, Phan, V, Chouari, T, Gardner, T, Goergen, N, Hayes, JDB, MacLeod, CS, McCormack, R, McKinley, A, McKinstry, S, Milligan, W, Ooi, L, Rafiq, NM, Sammut, T, Sinclair, E, Smith, M, Baker, C, Boulton, APR, Collins, J, Copley, HC, Fearnhead, N, Fox, H, Mah, T, McKenna, J, Naruka, V |
| المصدر: | Anaesthesia , 73 (10) pp. 1214-1222. (2018) |
| سنة النشر: | 2018 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | Acute kidney injury, angiotensin II receptor blockers, angiotensin‐converting enzyme inhibitors, postoperative complications |
| الوصف: | The peri-operative use of angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers is thought to be associated with an increased risk of postoperative acute kidney injury. To reduce this risk, these agents are commonly withheld during the peri-operative period. This study aimed to investigate if withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers peri-operatively reduces the risk of acute kidney injury following major non-cardiac surgery. Patients undergoing elective major surgery on the gastrointestinal tract and/or the liver were eligible for inclusion in this prospective study. The primary outcome was the development of acute kidney injury within seven days of operation. Adjusted multi-level models were used to account for centre-level effects and propensity score matching was used to reduce the effects of selection bias between treatment groups. A total of 949 patients were included from 160 centres across the UK and Republic of Ireland. From this population, 573 (60.4%) patients had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers withheld during the peri-operative period. One hundred and seventy-five (18.4%) patients developed acute kidney injury; there was no difference in the incidence of acute kidney injury between patients who had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers continued or withheld (107 (18.7%) vs. 68 (18.1%), respectively; p = 0.914). Following propensity matching, withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers did not demonstrate a protective effect against the development of postoperative acute kidney injury (OR (95%CI) 0.89 (0.58–1.34); p = 0.567). |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| Relation: | https://discovery.ucl.ac.uk/id/eprint/10058639/7/Collaborative-2018-Anaesthesia.pdf; https://discovery.ucl.ac.uk/id/eprint/10058639/ |
| الاتاحة: | https://discovery.ucl.ac.uk/id/eprint/10058639/7/Collaborative-2018-Anaesthesia.pdf https://discovery.ucl.ac.uk/id/eprint/10058639/ |
| Rights: | open |
| رقم الانضمام: | edsbas.5F587E1 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |