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Effects of ACE inhibitor/ARB therapy and long COVID on kidney disease: a retrospective cohort study using real-world data.
Zhang, Yue; Ba, Djibril M; Risher, Kathryn; Liao, Duanping; Parent, Leslie J; Ghahramani, Nasrollah; Chinchilli, Vernon M.
Afiliación
  • Zhang Y; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
  • Ba DM; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
  • Risher K; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
  • Liao D; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
  • Parent LJ; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
  • Ghahramani N; Department of Medicine, Penn State College of Medicine, Hershey, PA, USA.
  • Chinchilli VM; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
Clin Kidney J ; 17(7): sfae164, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39056070
ABSTRACT

Background:

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.

Methods:

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.

Results:

Our study included 18 168 long COVID and 181 680 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) 0.65-0.93]} in the NLCAU group compared with the NLCAN group. Conversely, long COVID was associated with increased risks of CKD [aHR 1.49 (95% CI 1.03-2.14)] and all-cause mortality [aHR 1.49 (95% CI 1.00-2.23)] when comparing LCANs with NLCANs. The additional analyses support the primary findings.

Conclusions:

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido