Association of Acute Increases in Plasma Creatinine after Renin-Angiotensin Blockade with Subsequent Outcomes

Clinical Journal of the American Society of Nephrology : CJASN
Edouard L FuJuan-Jesus Carrero

Abstract

Data from observational and interventional studies provide discordant results regarding the relationship between creatinine increase after renin-angiotensin system inhibition (RASi) and adverse outcomes. We compared health outcomes among patients with different categories of increase in creatinine upon initiation of RASi in a large population-based cohort. We performed a retrospective analysis of the Stockholm CREAtinine Measurements database, which contains complete information on diagnoses, medication dispensation claims, and laboratory test results for all Stockholm citizens accessing health care. Included were 31,951 adults initiating RASi during 2007-2011 with available pre- and postinitiation creatinine monitoring. Multivariable Cox regression was used to compare mortality, cardiovascular and ESKD events among individuals with different ranges of creatinine increases within 2 months after starting treatment. In a median follow-up of 3.5 years, acute increases in creatinine were associated with mortality (3202 events) in a graded manner: compared with creatinine increases <10%, a 10%-19% increase showed an adjusted hazard ratio (HR) of 1.15 (95% confidence interval [95% CI], 1.05 to 1.27); HR 1.22 (95% CI, 1.07 to 1.40) fo...Continue Reading

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Citations

Nov 28, 2020·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Edouard L FuJuan-Jesus Carrero
Dec 30, 2020·Journal of the American Society of Nephrology : JASN·Edouard L FuJuan J Carrero
Feb 11, 2020·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ian E McCoy, Glenn M Chertow
Mar 4, 2021·Journal of the American Society of Nephrology : JASN·Daniel M GreenMelissa M Hudson
Mar 4, 2021·Pharmacological Reviews·Franck Mauvais-JarvisJoshua B Rubin
Jul 17, 2021·Nature Reviews. Disease Primers·John A KellumHans-Joachim Anders
Nov 7, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Lorenzo SignoriniGiovanni Gambaro

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