{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:53:13Z","timestamp":1782928393825,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Withholding or continuing angiotensin\u2010converting enzyme inhibitors or angiotensin 2 receptor blockers peri\u2010operatively in non\u2010cardiac surgery remains controversial as they may result in intra\u2010operative hypotension and postoperative organ damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included patients prescribed angiotensin\u2010converting enzyme inhibitors or angiotensin 2 receptor blockers who underwent surgical procedures &gt;\u20091\u2009h duration under general or spinal anaesthesia from January 2012 to June 2022 in a single centre. We categorised patients by whether these drugs were withheld for 24\u2009h before surgery. We evaluated the association of withholding these drugs before non\u2010cardiac surgery with creatinine concentrations that increased \u2265\u200926.4\u2009\u03bcmol.l\n                      <jats:sup>\u20101<\/jats:sup>\n                      in the first 48 postoperative hours (acute kidney injury). We also analysed changes in creatinine concentrations and estimated glomerular filtration rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Angiotensin\u2010converting enzyme inhibitors or angiotensin 2 receptor blockers were withheld in 24,285 of 32,933 (74%) patients and continued in 8648 (26%) patients. We used propensity scores for drug discontinuation to match 8631 patient pairs who did or did not continue these drugs: acute kidney injury was recorded for 1791 (21%) patients who continued these drugs vs. 1587 (18%) who did not (OR (95%CI) 1.16 (1.08\u20131.25), p\u2009&lt;\u20090.001). Intra\u2010operative hypotension was recorded for 3892 (45%) patients who continued drugs vs. 3373 (39%) patients who did not (OR (95%CI) 1.28 (1.21\u20131.36), p\u2009&lt;\u20090.001). Continuing drugs was\u00a0independently associated with a mean increase in creatinine of 2.2\u2009\u03bcmol.l\n                      <jats:sup>\u20101<\/jats:sup>\n                      (p\u2009&lt;\u20090.001) and a mean decrease in estimated glomerular filtration rate of 1.4\u2009ml.min.1.73\u2009m\n                      <jats:sup>\u20102<\/jats:sup>\n                      (p\u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Continuing angiotensin\u2010converting enzyme inhibitors or angiotensin 2 receptor blockers 24\u2009h before non\u2010cardiac surgery was associated with intra\u2010operative hypotension and postoperative acute kidney injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16308","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T22:49:26Z","timestamp":1715640566000},"page":"937-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The association of withholding or continuing angiotensin\u2010converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non\u2010cardiac surgery"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4452-5944","authenticated-orcid":false,"given":"Jisun","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Kyun","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunghyeon","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeayoun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boram","family":"Park","sequence":"additional","affiliation":[{"name":"Biomedical Statistics Centre Research Institute for Future Medicine, Samsung Medical Centre  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeongman","family":"Jeon","sequence":"additional","affiliation":[{"name":"Division of Respiratory and Critical Care Medicine, Department of Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul South\u00a0Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MiHye","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre Sungkyunkwan University School of Medicine  Seoul 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