{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:52:06Z","timestamp":1773787926024,"version":"3.50.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T00:00:00Z","timestamp":1717891200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The association between angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and severe acute respiratory syndrome coronavirus 2 susceptibility, particularly via ACE-2 receptor upregulation in the kidneys, raises concerns about potential kidney disease risks in long coronavirus disease (COVID) patients. This study explores the association of ACEI\/ARB therapy on acute kidney injury (AKI), chronic kidney disease (CKD) and all-cause mortality in patients with and without long COVID.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study using TriNetX datasets was conducted, with diagnoses of long COVID via International Classification of Diseases, Tenth Revision (ICD-10) codes and prescription for ACEI\/ARB as the classification of four cohorts: long COVID ACEI\/ARB users (LCAUs), long COVID ACEI\/ARB non-users (LCANs), non-long COVID ACEI\/ARB users (NLCAUs) and non-long COVID ACEI\/ARB non-users (NLCANs). Multivariable stratified Cox proportional hazards regression models assessed the adjusted hazard ratios (aHRs) across groups. Additional analyses were conducted, including time-dependent exposure analysis and comparison with an active comparator, calcium channel blockers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our study included 18\u2009168 long COVID and 181\u2009680 propensity score-matched non-long COVID patients from October 2021 to October 2023. ACEI\/ARB use did not significantly affect the risk of AKI or CKD when comparing LCAUs with LCANs and NLCAUs with NLCANs. However, a protective effect against all-cause mortality was observed {aHR 0.79 [95% confidence interval (CI) 0.65\u20130.93]} in the NLCAU group compared with the NLCAN group. Conversely, long COVID was associated with increased risks of CKD [aHR 1.49 (95% CI 1.03\u20132.14)] and all-cause mortality [aHR 1.49 (95% CI 1.00\u20132.23)] when comparing LCANs with NLCANs. The additional analyses support the primary findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ACEI\/ARB treatment does not increase the incidence of CKD or AKI, regardless of long COVID status. However, long COVID itself is associated with increasing risks of kidney diseases and all-cause mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfae164","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T22:15:31Z","timestamp":1717798531000},"source":"Crossref","is-referenced-by-count":6,"title":["Effects of ACE inhibitor\/ARB therapy and long COVID on kidney disease: a retrospective cohort study using real-world data"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-0025","authenticated-orcid":false,"given":"Yue","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Penn State College of Medicine , Hershey, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Djibril M","family":"Ba","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Penn State College of Medicine , Hershey, PA , 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