Skip to main content

ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Renal Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1343647

Pre-operative maintenance of angiotensin-converting enzyme inhibitors is not associated with acute kidney injury following cardiac surgery patients with cardiopulmonary bypass: a propensity-matched multicentric analysis

Provisionally accepted
Pierre Guilleminot Pierre Guilleminot 1*Stefan Andrei Stefan Andrei 2Maxime Nguyen Maxime Nguyen 1Osama Abou-Arab Osama Abou-Arab 3Emmanuel Besnier Emmanuel Besnier 4Belaid Bouhemad Belaid Bouhemad 1Pierre-Gregoire Guinot Pierre-Gregoire Guinot 1
  • 1 Centre Hospitalier Regional Universitaire De Dijon, Dijon, France
  • 2 Hôpital Bichat-Claude-Bernard, Paris, France
  • 3 Centre Hospitalier Universitaire (CHU) d'Amiens, Amiens, Picardy, France
  • 4 Centre Hospitalier Universitaire (CHU) de Rouen, Rouen, France

The final, formatted version of the article will be published soon.

    Objective: We investigated the effects of maintenance of angiotensin-converting-enzyme inhibitors (ACE-inhibitor) the day of the surgery on the incidence of postoperative acute kidney injury (AKI) and cardiac events in patients undergoing cardiac surgery.We performed a multicentric observational study with propensity matching on 1072 patients treated with ACE-inhibitors. We collected their baseline demographic data, comorbidities, operative and postoperative outcomes. AKI was defined by KDIGO (Kidney Disease: Improving Global Outcome).Results: Maintenance of ACE-inhibitor was not associated with increased risk of AKI (OR: 1.215 (CI95%:0.657-2.24)), p = 0.843, 71 patients (25.1%) vs 68 patients (24%)). Multivariate logistic regression and sensitive analysis did not demonstrate any association between ACE-inhibitor maintenance and AKI following cardiac surgery (OR: 1.03 (CI95%:0.81-1.3)). No statistically significant difference occurs in terms of incidence of cardiogenic shock (OR: 1.315 (CI95%:0.620-2.786)), stroke (OR: 3.313 (CI95%:0.356-27.523)), vasoplegia (OR: 0.741 (CI95%:0.419-1.319)), postoperative atrial fibrillation (OR: 1.710 (CI95%:0.936-3.122)), or mortality (OR: 2.989 (CI95%:0.343-26.034)). ICU and hospital length of stays did not differ (3 [2;5] vs 3 [2;5] days, p= 0.963 and 9.5 [8;12] vs 10 [8;14] days, p =0.638).Our study revealed that maintenance of ACE-inhibitors the day of the surgery was not associated with increased postoperative AKI. ACE-inhibitors maintenance was also not associated with increase rate of postoperative major cardiovascular events (arterial hypotension, vasopressors use, death).

    Keywords: Acute Kidney Injury, Angiotensin-Converting Enzyme Inhibitors, cardiac surgery, Cardio-pulmonary bypass, Atrial Fibrillation

    Received: 24 Nov 2023; Accepted: 28 Mar 2024.

    Copyright: © 2024 Guilleminot, Andrei, Nguyen, Abou-Arab, Besnier, Bouhemad and Guinot. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Pierre Guilleminot, Centre Hospitalier Regional Universitaire De Dijon, Dijon, France

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.