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This illustrates a key consequence of CKD, i.e. premature mortality. Since nephroprotective drugs such as renin\u2013angiotensin system (RAS) blockers and sodium\u2013glucose transport protein 2 (SGLT2) inhibitors decrease glomerular hyperfiltration, they may be stopped following an episode of acute kidney injury (AKI). This may theoretically modify the risks of subsequent events, ranging from hyperkalaemia to CKD progression to cardiovascular events, but the evidence so far has been inconsistent. Roemer et al. have now addressed the shortcomings of prior studies. In a population of mostly elderly (median age 78 years) prevalent users of RAS blockers with an indication for this therapy and who survived for at least 3 months after discharge following a hospitalization characterized by moderate to severe AKI, roughly 50% had stopped RAS blockade at 3 months. Stopping RAS blockade was associated with an increased risk of a primary composite outcome of death, myocardial infarction and stroke, of which a large majority (80%) of events were deaths. In contrast, the risk of hyperkalaemia was reduced and the risk of repeated AKI, CKD progression or heart failure hospitalization was unchanged in patients who stopped RAS blockers. These findings call for a re-evaluation of the practice of stopping RAS blockers in the long-term following AKI and suggest that studies are needed regarding similar practices for SGLT2 inhibitors.<\/jats:p>","DOI":"10.1093\/ckj\/sfac024","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T12:23:19Z","timestamp":1643631799000},"page":"1037-1040","source":"Crossref","is-referenced-by-count":3,"title":["Stopping kidney protection in the elderly following acute kidney injury: think mortality"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-5279","authenticated-orcid":false,"given":"Sol","family":"Carriazo","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-9523","authenticated-orcid":false,"given":"Alberto","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"2022053122134240800_bib1","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"2022053122134240800_bib2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.nefroe.2019.01.007","article-title":"The Spanish Society of Nephrology (SENEFRO) commentary to the Spain GBD 2016 report: keeping chronic kidney disease out of sight of health authorities will only magnify the problem","volume":"39","author":"Ortiz","year":"2019","journal-title":"Nefrologia (Engl Ed)"},{"key":"2022053122134240800_bib3","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1016\/S0140-6736(14)60384-6","article-title":"Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure","volume":"383","author":"Ortiz","year":"2014","journal-title":"Lancet"},{"key":"2022053122134240800_bib4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/ckj\/sfaa271","article-title":"The ERA-EDTA Registry Annual Report 2018: a summary","volume":"14","author":"Kramer","year":"2020","journal-title":"Clin Kidney J"},{"key":"2022053122134240800_bib5","article-title":"European Kidney Patients' Federation (EKPF), Federaci\u00f3n Nacional de Asociaciones para la Lucha Contra las Enfermedades del Ri\u00f1\u00f3n (ALCER), Fundaci\u00f3n Renal \u00cd\u00f1igo \u00c1lvarez deTtoledo (FRIAT), Red de Investigaci\u00f3n Renal (REDINREN), Resultados en Salud 2040 (RICORS2040), Sociedad Espa\u00f1ola de Nefrolog\u00eda (SENEFRO) council, Sociedad Espa\u00f1ola de Trasplante (SET) council, Organizaci\u00f3n Nacional de Trasplantes (ONT). 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