European Journal of Biomedical and Pharmaceutical Sciences

PRESCRIPTION OF RENIN-ANGIOTENSIN SYSTEM BLOCKERS AND RISK OF ACUTE KIDNEY INJURY IN PATIENTS WITH DIABETES MELLITUS: RETROSPECTIVE STUDY

Akshitha D. Ajay, Gini C. Johns, Mareena Mathew*, Athira S. and Cijo George

ABSTRACT

The development of AKI is thought to be significantly correlated with the use of ACE inhibitors and ARBs. Patients who have both hypertension and type 2 diabetes mellitus are more likely to experience renal problems than those who either have hypertension or Type 2 diabetes mellitus. A retrospective observational cohort study conducted was conducted with 200 in patients among the study subjects of the age group of 18 years and above. Majority of the cases were males (50.5%) than females (49.5%). Cockcroft-Gault-eGFR was 57.90±21.6 mL/min in the ACEI group and 24.2 mL/min in the ARB group. Average baseline creatinine(mg/dL) of non-exposed group was 1±0.82 mg/dL and exposed group was 0.96 ±0.2 mg/dL. ACEIs were administrated to 1% of the patients (1/100) and ARBs to 99% (99/100). The highest incidence percentage of increased creatinine according to the ARB type was associated with the use of telmisartan 10.7% (7/65 exposed), and olmesartan 14.2% (2/14 exposed), losartan 15.38% (2/13 exposed). A total of 11 (5.5%) patients developed AKI. From a total of 200 cases, majority had stage 1 (3.5%) followed by stage 2 (2.5%) and stage 3 (1%) AKI. There was a significant association between stages of AKI and administration of ARBS/ACE -inhibitors (χ2= 8.633, p<0.05). Relative risk of AKI and administration of ARBS/ACE -inhibitors was found to be 5.50 (χ2= 6.664, df= 1, p= 0.010**).

Keywords: Angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARB), acute kidney injury (AKI), estimated glomerular filtration rate (eGFR).