Association between exposure to angiotensin-converting enzyme inhibitors and angiotensin receptor blockers prior to septic shock and acute kidney injury / Asociación entre la exposición previa a inhibidores de la enzima conversora de la angiotensina y los antagonistas de los receptores de la angiotensina en pacientes con fracaso renal agudo y shock séptico
Med. intensiva (Madr., Ed. impr.)
; 41(1): 21-27, ene.-feb. 2017. graf, tab
Artigo
em Inglês
| IBECS
| ID: ibc-160092
Biblioteca responsável:
ES1.1
Localização: BNCS
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.INTERVENTIONS:
None. 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.CONCLUSIONS:
The use of ACEIs/ARBs before septic shock episodes was correlated to AKI development and severity, but did not affect the recovery of kidney function after sepsis resolution
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
ODS3 - Meta 3.9 Reduzir as mortes por produtos químicos y contaminação do ar, água e solo
Problema de saúde:
Exposições Ocupacionais
Base de dados:
IBECS
Assunto principal:
Choque Séptico
/
Injúria Renal Aguda
/
Antagonistas de Receptores de Angiotensina
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Med. intensiva (Madr., Ed. impr.)
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
University Hospital Marqués de Valdecilla/Spain