Acute Kidney Injury in Patients Continued on Renin-Angiotensin System Blockers During Hospitalization

Numan Alabdan, Elvira O. Gosmanova, Nhu Quynh T Tran, Carrie S. Oliphant, Hu Pan, Joyce Broyles, Joanna Laizure

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Acute kidney injury (AKI) is common in hospitalized patients and is associated with adverse outcomes. This study aimed to evaluate patient characteristics and interventions during hospitalization associated with the development of AKI in patients continued on renin-angiotensin system (RAS) blockers during hospitalization. Methods A retrospective study of 184 adult patients admitted between January 2012 and September 2014 and continued on RAS blockers was conducted. Risk factors for AKI were compared between AKI (n = 92) and non-AKI (n = 92) groups. Results Patients who developed hospital-acquired AKI had a higher baseline serum creatinine (1.2 ± 0.4 versus 1 ± 0.3 mg/dL, P < 0.001) and lower estimated glomerular filtration rate (54 ± 10 versus 57 ± 7 mL/minute/1.73 m2, P = 0.03) compared with patients who did not develop AKI. Patients who developed AKI were also more likely to be admitted to the intensive care unit, have surgical procedures, have hypotension and be prescribed loop diuretics. The presence of chronic kidney disease and hypotension were risk factors associated with AKI development. In addition, the AKI group had a significantly longer length of stay (14 days versus 8 days, P < 0.0001) and had a higher rate of all-cause hospital mortality (9% versus 1%, P = 0.03). Conclusions Patients with chronic kidney disease, hypotension and those undergoing surgeries were more likely to develop AKI while receiving RAS blockers. During hospitalization, temporary discontinuation of these medications may be warranted in patients with these characteristics.

Original languageEnglish (US)
Pages (from-to)172-177
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume353
Issue number2
DOIs
StatePublished - 2017

Fingerprint

Renin-Angiotensin System
Acute Kidney Injury
Hospitalization
Hypotension
Chronic Renal Insufficiency
Sodium Potassium Chloride Symporter Inhibitors
Hospital Mortality
Glomerular Filtration Rate
Intensive Care Units
Length of Stay
Creatinine
Retrospective Studies
Kidney
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Acute Kidney Injury in Patients Continued on Renin-Angiotensin System Blockers During Hospitalization. / Alabdan, Numan; Gosmanova, Elvira O.; Tran, Nhu Quynh T; Oliphant, Carrie S.; Pan, Hu; Broyles, Joyce; Laizure, Joanna.

In: American Journal of the Medical Sciences, Vol. 353, No. 2, 2017, p. 172-177.

Research output: Contribution to journalArticle

Alabdan, Numan ; Gosmanova, Elvira O. ; Tran, Nhu Quynh T ; Oliphant, Carrie S. ; Pan, Hu ; Broyles, Joyce ; Laizure, Joanna. / Acute Kidney Injury in Patients Continued on Renin-Angiotensin System Blockers During Hospitalization. In: American Journal of the Medical Sciences. 2017 ; Vol. 353, No. 2. pp. 172-177.
@article{d41f451243864032b184292bd6075846,
title = "Acute Kidney Injury in Patients Continued on Renin-Angiotensin System Blockers During Hospitalization",
abstract = "Background Acute kidney injury (AKI) is common in hospitalized patients and is associated with adverse outcomes. This study aimed to evaluate patient characteristics and interventions during hospitalization associated with the development of AKI in patients continued on renin-angiotensin system (RAS) blockers during hospitalization. Methods A retrospective study of 184 adult patients admitted between January 2012 and September 2014 and continued on RAS blockers was conducted. Risk factors for AKI were compared between AKI (n = 92) and non-AKI (n = 92) groups. Results Patients who developed hospital-acquired AKI had a higher baseline serum creatinine (1.2 ± 0.4 versus 1 ± 0.3 mg/dL, P < 0.001) and lower estimated glomerular filtration rate (54 ± 10 versus 57 ± 7 mL/minute/1.73 m2, P = 0.03) compared with patients who did not develop AKI. Patients who developed AKI were also more likely to be admitted to the intensive care unit, have surgical procedures, have hypotension and be prescribed loop diuretics. The presence of chronic kidney disease and hypotension were risk factors associated with AKI development. In addition, the AKI group had a significantly longer length of stay (14 days versus 8 days, P < 0.0001) and had a higher rate of all-cause hospital mortality (9{\%} versus 1{\%}, P = 0.03). Conclusions Patients with chronic kidney disease, hypotension and those undergoing surgeries were more likely to develop AKI while receiving RAS blockers. During hospitalization, temporary discontinuation of these medications may be warranted in patients with these characteristics.",
author = "Numan Alabdan and Gosmanova, {Elvira O.} and Tran, {Nhu Quynh T} and Oliphant, {Carrie S.} and Hu Pan and Joyce Broyles and Joanna Laizure",
year = "2017",
doi = "10.1016/j.amjms.2016.09.012",
language = "English (US)",
volume = "353",
pages = "172--177",
journal = "American Journal of the Medical Sciences",
issn = "0002-9629",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Acute Kidney Injury in Patients Continued on Renin-Angiotensin System Blockers During Hospitalization

AU - Alabdan, Numan

AU - Gosmanova, Elvira O.

AU - Tran, Nhu Quynh T

AU - Oliphant, Carrie S.

AU - Pan, Hu

AU - Broyles, Joyce

AU - Laizure, Joanna

PY - 2017

Y1 - 2017

N2 - Background Acute kidney injury (AKI) is common in hospitalized patients and is associated with adverse outcomes. This study aimed to evaluate patient characteristics and interventions during hospitalization associated with the development of AKI in patients continued on renin-angiotensin system (RAS) blockers during hospitalization. Methods A retrospective study of 184 adult patients admitted between January 2012 and September 2014 and continued on RAS blockers was conducted. Risk factors for AKI were compared between AKI (n = 92) and non-AKI (n = 92) groups. Results Patients who developed hospital-acquired AKI had a higher baseline serum creatinine (1.2 ± 0.4 versus 1 ± 0.3 mg/dL, P < 0.001) and lower estimated glomerular filtration rate (54 ± 10 versus 57 ± 7 mL/minute/1.73 m2, P = 0.03) compared with patients who did not develop AKI. Patients who developed AKI were also more likely to be admitted to the intensive care unit, have surgical procedures, have hypotension and be prescribed loop diuretics. The presence of chronic kidney disease and hypotension were risk factors associated with AKI development. In addition, the AKI group had a significantly longer length of stay (14 days versus 8 days, P < 0.0001) and had a higher rate of all-cause hospital mortality (9% versus 1%, P = 0.03). Conclusions Patients with chronic kidney disease, hypotension and those undergoing surgeries were more likely to develop AKI while receiving RAS blockers. During hospitalization, temporary discontinuation of these medications may be warranted in patients with these characteristics.

AB - Background Acute kidney injury (AKI) is common in hospitalized patients and is associated with adverse outcomes. This study aimed to evaluate patient characteristics and interventions during hospitalization associated with the development of AKI in patients continued on renin-angiotensin system (RAS) blockers during hospitalization. Methods A retrospective study of 184 adult patients admitted between January 2012 and September 2014 and continued on RAS blockers was conducted. Risk factors for AKI were compared between AKI (n = 92) and non-AKI (n = 92) groups. Results Patients who developed hospital-acquired AKI had a higher baseline serum creatinine (1.2 ± 0.4 versus 1 ± 0.3 mg/dL, P < 0.001) and lower estimated glomerular filtration rate (54 ± 10 versus 57 ± 7 mL/minute/1.73 m2, P = 0.03) compared with patients who did not develop AKI. Patients who developed AKI were also more likely to be admitted to the intensive care unit, have surgical procedures, have hypotension and be prescribed loop diuretics. The presence of chronic kidney disease and hypotension were risk factors associated with AKI development. In addition, the AKI group had a significantly longer length of stay (14 days versus 8 days, P < 0.0001) and had a higher rate of all-cause hospital mortality (9% versus 1%, P = 0.03). Conclusions Patients with chronic kidney disease, hypotension and those undergoing surgeries were more likely to develop AKI while receiving RAS blockers. During hospitalization, temporary discontinuation of these medications may be warranted in patients with these characteristics.

UR - http://www.scopus.com/inward/record.url?scp=85016184585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016184585&partnerID=8YFLogxK

U2 - 10.1016/j.amjms.2016.09.012

DO - 10.1016/j.amjms.2016.09.012

M3 - Article

VL - 353

SP - 172

EP - 177

JO - American Journal of the Medical Sciences

JF - American Journal of the Medical Sciences

SN - 0002-9629

IS - 2

ER -