{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:36:19Z","timestamp":1790253379634,"version":"4.1.0"},"reference-count":0,"publisher":"BMJ","issue":"11","funder":[{"name":"United States National Institute of Diabetes and Digestive and Kidney Diseases","award":["DK 113381"],"award-info":[{"award-number":["DK 113381"]}]},{"name":"Program for Clinical Research Infrastructure"},{"name":"Linexfonden"},{"DOI":"10.13039\/501100010983","name":"The Health Research Fund of Central Denmark Region","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>It is unknown whether preoperative use of ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) affects the risk of acute kidney injury (AKI) after colorectal cancer (CRC) surgery. We assessed the impact of preoperative ACE-I\/ARB use on risk of AKI after CRC surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational cohort study. Patients were divided into three exposure groups\u2014current, former and non-users\u2014through reimbursed prescriptions within 365 days before the surgery. AKI within 7 days after surgery was defined according to the current Kidney Disease Improving Global Outcome consensus criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Population-based Danish medical databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 9932 patients undergoing incident CRC surgery during 2005\u20132014 in northern Denmark were included through the Danish Colorectal Cancer Group Database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measure<\/jats:title><jats:p>We computed cumulative incidence proportions (risk) of AKI with 95% CIs for current, former and non-users of ACE-I\/ARB, including death as a competing risk. We compared current and former users with non-users by computing adjusted risk ratios (aRRs) using log-binomial regression adjusted for demographics, comorbidities and CRC-related characteristics. We stratified the analyses of ACE-I\/ARB users to address any difference in impact within relevant subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-one per cent were ACE-I\/ARB current users, 6.4% former users and 72.3% non-users. The 7-day postoperative AKI risk for current, former and non-users was 26.4% (95% CI 24.6% to 28.3%), 25.2% (21.9% to 28.6%) and 17.8% (17.0% to 18.7%), respectively. The aRRs of AKI were 1.20 (1.09 to 1.32) and 1.16 (1.01 to 1.34) for current and former users, compared with non-users. The relative risk of AKI in current compared with non-users was consistent in all subgroups, except for higher aRR in patients with a history of hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Being a current or former user of ACE-I\/ARBs is associated with an increased risk of postoperative AKI compared with non-users. Although it may not be a drug effect, users of ACE-I\/ARBs should be considered a risk group for postoperative AKI.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2019-032964","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T02:46:00Z","timestamp":1574390760000},"page":"e032964","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Renin\u2013angiotensin system blocker use and the risk of acute kidney injury after colorectal cancer surgery: a population-based cohort study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-9836","authenticated-orcid":false,"given":"Charlotte","family":"Slagelse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Gammelager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene Hjerrild","family":"Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen D","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik T Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian F","family":"Christiansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,21]]},"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-032964","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T02:07:11Z","timestamp":1601086031000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-032964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,21]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bmjopen-2019-032964"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-032964","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}