Acute Kidney Injury

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Acute Kidney Injury
07/11/2013

Associations with acute kidney injury should not deter people from taking blood pressure medication

Some blood pressure medications are known risk factors for acute kidney injury (AKI) - a sudden deterioration in kidney function.  Cambridge scientists have found an association between the increased prescriptions for ACE inhibitors (and similar drugs) and increased hospital admissions for acute kidney injury.

On behalf of Blood Pressure UK, Dr Rebecca Sucking, Consultant Nephrologist says:

“ACE-I and ARBs are life-saving medications which not only reduce blood pressure, but also reduce the progression of kidney disease, heart failure and diabetes.  However, AKI has been shown to be a recognised, but avoidable, side effect for some seriously ill people on these medications.  It is imperative that prescribing GPs advise their patients on how to take their medication safety, and not to ignore any serious side effects they may have. 

“Patients are put on to ACE-I or ARBs because they are otherwise at an increased risk of strokes and heart attacks, both of which can be fatal.  It is likely that prescriptions for blood pressure lowering medications will continue to increase as we try to reduce the amount of deaths from strokes and heart attacks, so it is important we all work together to educate patients on the health risks and benefits.”

The research looked at 2007/8 to 2010/11 data and found a 52 per cent increase in acute kidney injury admissions. During this same period of time, there was an increase in the number of prescriptions for ACE inhibitors and ARAs issued by GP surgeries by 16 per cent.  They estimate that one in seven cases of acute kidney injury could be due to increased prescriptions for these drugs.

This is the first time that a study has been able to assess the extent to which these medications are linked to acute kidney injury. However, the researchers emphasise that we cannot assume that the medication was a direct cause of the acute kidney injury in this study, and no one should stop taking these medications unless advised by their doctor to do so.

Dr Rupert Payne, senior author of the study from the University of Cambridge's Institute of Public Health, said: "There has been lots of anecdotal evidence suggesting these drugs may be a contributory factor in patients developing acute kidney injury, and this work gives us an opportunity to estimate the size of the problem, as well as making clinicians and patients more aware of the importance of using these drugs in accordance with current clinical guidelines.”

Katharine Jenner, Chief Executive of Blood Pressure UK says “High blood pressure leads to 350 strokes and heart attacks every day in the UK which could otherwise be prevented, so it is essential that the condition is properly and safely managed; either through lifestyle changes or through blood pressure-lowering medication. 

“If people are concerned about the effects of their medications, we would urge them to continue taking them, but to visit their GP for advice.”

The research will be available at http://dx.plos.org/10.1371/journal.pone.0078465



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