| Autor: |
Drake, T.M., Cheung, L.K., Gaba, F., Glasbey, J., Griffiths, N., Helliwell, R.J., Huq, T., Khaw, R., Mayes, J., Khan, S., Rafiq, N., Woin, E., Fitzgerald, J.E., Harrison, E.M., Nepogodiev, D., Bath, M., Borakati, A., Burke, J., Claireaux, H., Deekonda, P., Gundogan, B., Joyce, H., Kamarajah, S., Khatri, C., Kong, C., McLean, K.A., 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, F.S., Teo, R., Sim, D.P.Y., Logan, A.E., 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, J.D.B., MacLeod, C.S., McCormack, R., McKinley, A., McKinstry, S., Milligan, W., Ooi, L., Rafiq, N.M., Sammut, T., Sinclair, E., Smith, M., Baker, C., Boulton, A.P.R., Collins, J., Copley, H.C., Fearnhead, N., Fox, H., Mah, T., McKenna, J., Naruka, V., STARSurg Collaborative, . |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| ISSN: |
0003-2409 |
| Popis: |
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). |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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