ArticleCritical care explorations2025
Prior Use of Renin-Angiotensin System Inhibitors and Risk of Renal Replacement Therapy in Critically Ill Elderly Patients With Sepsis: A Population-Based Cohort Study.
Article in Critical care explorations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Targeting the renin-angiotensin system in sepsis-associated AKI: from pathophysiology to precision medicine.Frontiers in immunology · 2026Review
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Authors and funding
3 authors.
Funding
Abstract
objectivesWe sought to estimate the association between chronic use of renin-angiotensin system inhibitors and acute kidney injury requiring renal replacement therapy in critically ill adult patients with sepsis.
designPopulation-based cohort study in Ontario, Canada.
settingICUs in Ontario, Canada, between April 2008 and March 2019. PATIENTS: Elderly patients admitted to an ICU with a sepsis diagnosis; we excluded patients with established indications of renin-angiotensin system inhibitors.
interventionsThe prior use (i.e., within 100 d of hospitalization) of an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker served as the main exposure of interest; the active comparator was the prior use of calcium channel blockers. MEASUREMENTS AND MAIN
resultsAcute kidney injury requiring renal replacement therapy was the primary outcome. Septic shock and all-cause mortality at 30 days served as secondary outcomes. We fitted multivariable modified Poisson regression models to adjust for potential confounders; associations were reported as risk ratios (RRs) alongside 95% CIs. We included 8621 patients, of whom 81% received a renin-angiotensin system inhibitor; mean age was 78 years. Renal replacement therapy was performed in 3.2% of patients; compared with the prior use of a calcium channel blocker, prior use of a renin-angiotensin system inhibitor was associated with a higher risk of acute kidney injury and renal replacement therapy (RR, 1.57; 95% CI, 1.10-2.24), septic shock (RR, 1.18; 95% CI, 1.04-1.33), but not all-cause mortality at 30 days (RR, 0.93; 95% CI, 0.88-1.01). Our results were robust across sensitivity analyses.
conclusionsChronic use of a renin-angiotensin system inhibitor is associated with a higher risk of renal replacement therapy and septic shock in adult patients with sepsis.
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