Renin Angiotensin Aldosterone System Blockade (RAASB) May Be Beneficial in Patients with Acute Kidney Injury (AKI)

Dallas, TX – Exposure to renin angiotensin aldosterone system blockade (i.e. RAASB) may have a protective effect in patients with hospital-acquired acute kidney injury (AKI), according to new research presented at the National Kidney Foundation's 2015 Spring Clinical Meetings.

There are a number of different etiologies for hospital-acquired AKI leading to an abrupt decrease in kidney function. AKI is associated with significant increases in duration of hospitalization, re-hospitalization, and mortality. Even in those who recover from AKI, there appears to be link to development of chronic kidney disease later in life.

In an examination of medical records for 46,580 hospital admissions, researchers led by Christian Suarez, MD at Albert Einstein College of Medicine and its University Hospital, Montefiore Medical Center, evaluated patients that had AKI and were exposed to RAASB, a category of medications commonly used to lower blood pressure.

“RAASB has been shown to have therapeutic benefits in patients with diabetic kidney disease and heart disease, but was previously suspected to cause AKI in hospitalized patients,” Dr. Suarez said.

Analysis showed that patients who developed AKI had higher risk of mortality, but RAASB was not associated with a higher risk of developing AKI. Instead, patients that had exposure to RAASB had a lower risk of mortality overall compared to patients who did not receive RAASB (independent of AKI status).

“I was surprised by these results since RAASB is commonly associated with hospital-acquired AKI and early discontinuation is typically recommended. Because our study did not link RAASB with causing AKI, and actually showed decreased risk of death, I think that clinicians should better determine whether RAASB is the cause or contributor of a patient’s AKI before discontinuing these medications,” said Dr. Suarez.

In the United States, AKI is one of the most serious and common health complications, occurring in up to 20% of all hospitalized patients and over 45% of patients in a critical care setting.

“AKI increases mortality, hospitalization, and the risk for developing chronic kidney disease later in life. It is important to develop strategies to prevent AKI and protect the kidneys whenever possible,” said. Dr. Kerry Willis, Chief Scientific Officer at the National Kidney Foundation. “This study brings into question the value of discontinuing RAASB drugs in hospitalized patients to reduce the risk of AKI and supports the need for further research to evaluate this AKI prevention strategy.”

 

The National Kidney Foundation (NKF) is the leading organization in the U.S. dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families, and tens of millions of Americans at risk. For more information, visit www.kidney.org.