Increased Creatinine after Starting ACEIs/ARBs May Increase Cardiorenal Risk

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Patients who have even relatively small increases in creatinine after starting angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) treatment are at increased risk of adverse cardiorenal events, suggests a study in the British Medical Journal.

Using linked UK primary care and hospital databases, the researchers identified 122,363 patients who initiated treatment with ACEIs or ARBs between 1997 and 2014. Of these, 1.7% had creatinine increases of 30% or more after starting renin-angiotensin system blockade. Rates of end stage renal disease, myocardial infarction, heart failure, and death were compared for patients with and without a 30% increase in creatinine, with