ArticleBMJ open2016
Prescription of renin-angiotensin system blockers and risk of acute kidney injury: a population-based cohort study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between antihypertensive treatment and adverse events: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- Rates, predictors, and mortality of sepsis-associated acute kidney injury: a systematic review and meta-analysis.BMC nephrology · 2020Pooled it
- Efficacy and safety of dual renin-angiotensin system (RAS) blockade for non-elderly diabetic kidney disease patients with preserved eGFR.International urology and nephrology · 2025Trial
- Trial
- Lisinopril versus lisinopril and losartan for mild childhood IgA nephropathy: a randomized controlled trial (JSKDC01 study).Pediatric nephrology (Berlin, Germany) · 2019Trial
- Effect of antihypertensive medication reduction on short-term blood pressure control in older adults: calibration of OPTiMISE trial results to real-world primary care data.Age and ageing · 2026Article
- Renin-angiotensin system inhibitors (RASi) are not nephrotoxic - they protect the kidneys and the heart.Clinical medicine (London, England) · 2026Review
- Discontinuation of RAS Inhibition After an Acute Decline in Estimated Glomerular Filtration Rate.JAMA network open · 2026Article
- Discontinuation of Renin-Angiotensin System Inhibitors during Acute Kidney Injury Episode and All-Cause Mortality: Target Trial Emulation Studies.Journal of the American Society of Nephrology : JASN · 2025Article
- Population risk predictors of major adverse kidney events attributed to focal segmental glomerulosclerosis from the CURE-CKD registry.BMC nephrology · 2025Article
- Predictive Nomogram for Acute Kidney Injury Risk with Vancomycin and Piperacillin Tazobactam in Sepsis Treatment.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Chronic kidney disease in older adults: trends in prevalence and healthcare service quality from 2012 to 2018.Clinical kidney journal · 2025Article
- Adverse events with co-prescription of angiotensin receptor blockers and clarithromycin compared to azithromycin: A population-based retrospective cohort study.Pharmacotherapy · 2025Article
- Population Risk Predictors of Major Adverse Kidney Events in Patients with Focal Segmental Glomerulosclerosis from the CURE-CKD Registry.Research square · 2025Article
- Prevalent and new use of common drugs for the incidence of community-acquired acute kidney injury: cohort and case-crossover study.Scientific reports · 2024Article
- Renin-angiotensin system inhibitors prescriptions in Chinese hospitalized chronic kidney disease patients.World journal of clinical cases · 2024Article
- Role of the Renin Angiotensin Aldosterone System in the Pathogenesis of Sepsis-Induced Acute Kidney Injury: A Systematic Review.Journal of clinical medicine · 2023Review
- A Real-World Analysis of Post-Marketing Surveillance Data Assessing the Incidence of Hyperkalemia or Acute Kidney Injury in Patients on Angiotensin-Converting Enzyme Inhibitors Versus Angiotensin-Receptor Blockers.Reviews in cardiovascular medicine · 2023Article
- Medical Telemonitoring for the Management of Hypertension in Older Patients in Japan.International journal of environmental research and public health · 2023Review
- Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment.Cureus · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB) and risk of acute kidney injury (AKI). STUDY
designWe conducted a new-user cohort study of the rate of AKI among users of common antihypertensives.
settingUK primary care practices contributing to the Clinical Practice Research Datalink (CPRD) eligible for linkage to hospital records data from the Hospital Episode Statistics (HES) database between April 1997 and March 2014.
participantsNew users of antihypertensives: ACEI/ARB, β-blockers, calcium channel blockers and thiazide diuretics. OUTCOMES: The outcome was first episode of AKI. We estimated incidence rate ratio (RR) for AKI during time exposed to ACEI/ARB compared to time unexposed, adjusting for age, sex, comorbidities, use of other antihypertensive drugs and calendar period using Poisson regression. Covariates were time updated.
resultsAmong 570 445 participants, 303 761 were prescribed ACEI/ARB with a mean follow-up of 4.1 years. The adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 1.12 (95% CI 1.07 to 1.17). This relative risk varied depending on absolute risk of AKI, with lower or no increased relative risk from the drugs among those at greatest absolute risk. For example, among people with stage 4 chronic kidney disease (who had 6.69 (95% CI 5.57 to 8.03) times higher rate of AKI compared to those without chronic kidney disease), the adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 0.66 (95% CI 0.44 to 0.97) in contrast to 1.17 (95% CI 1.09 to 1.25) among people without chronic kidney disease.
conclusionsTreatment with ACEI/ARB is associated with only a small increase in AKI risk while individual patient characteristics are much more strongly associated with the rate of AKI. The degree of increased risk varies between patient groups.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.