ClinicalCodes.org

An online clinical codes repository to improve validity and reproducibility of medical database research

Research article:

Renin-angiotensin system blockade and risk of acute kidney injury: a population-based cohort study

Reference:

Kathryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaran, Laurie A Tomlinson(2015) Renin-angiotensin system blockade and risk of acute kidney injury: a population-based cohort study. Submitted, doi:

Link to article
Abstract
Objective: To investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), and risk of acute kidney injury (AKI). Design: A time-updated, new-user cohort study among people initiating common antihypertensives (ACEI/ARB, beta-blockers, calcium channel blockers and thiazide diuretics) in primary care between April 1997 and March 2014. Participants: Adults initiating antihypertensive drug treatment, with at least one year of registration prior to first prescription, identified from UK primary care practices contributing to the Clinical Practice Research Datalink and eligible for linkage to hospital records data from the Hospital Episode Statistics database. Main outcome measures: Incidence rate ratio (RR) for first episode of AKI during time exposed to ACEI/ARB compared to time unexposed, estimated using Poisson regression adjusted for age, sex, comorbidities, use of other antihypertensive drugs, and calendar period. Results: Among 570,443 participants with a median follow-up of 2.8 years (IQR 0.4 to 7) there were 15,004 first cases of AKI. The overall crude rate of AKI was 6.4/1,000 person years at risk (95% CI 6.30 to 6.50) but varied from 1.63 (1.43 to 1.86) to 662.53 (538.98 to 814.40) depending on, age, comorbidities, and other prescribed drugs. The adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 1.18 (95% CI 1.13 to 1.23) which was attenuated to 1.12 (95% CI 1.08 to 1.17) after adjustment for non-thiazide diuretic therapy. There was an interaction for the risk of AKI between people using loop diuretics and ACEI/ARB. For those taking loop diuretics, the adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 0.99 (95% CI 0.92 to 1.06) but it was 1.18 (95% CI 1.13 to 1.24) among people not-exposed to loop diuretics (p<0.001). Conclusions: Treatment with ACEI/ARB alone appears to be associated with a small increase in the rate of AKI which is largely seen among people with low absolute risk of AKI. Among people requiring loop diuretics, who have a high absolute risk of AKI, treatment with ACEI/ARB had no measurable association with AKI.
Author for correspondence
Kathryn Mansfield
Email for correspondence
kathryn.mansfield@lshtm.ac.uk

Code list: res30: Hypertension

149 codes in list

Code Coding system Description Entity type List name
14A2.00 Read h/o: hypertension diagnostic res30: Hypertension
1JD..00 Read suspected hypertension diagnostic res30: Hypertension
2126100 Read hypertension resolved diagnostic res30: Hypertension
212K.00 Read hypertension resolved diagnostic res30: Hypertension
246M.00 Read white coat hypertension diagnostic res30: Hypertension
662..12 Read hypertension monitoring diagnostic res30: Hypertension
6624 Read borderline hyperten:yearly obs diagnostic res30: Hypertension
6627 Read good hypertension control diagnostic res30: Hypertension
6628 Read poor hypertension control diagnostic res30: Hypertension
6629 Read hypertension:follow-up default diagnostic res30: Hypertension
662b.00 Read moderate hypertension control diagnostic res30: Hypertension
662c.00 Read hypertension six month review diagnostic res30: Hypertension
662d.00 Read hypertension annual review diagnostic res30: Hypertension
662F.00 Read hypertension treatm. started diagnostic res30: Hypertension
662G.00 Read hypertensive treatm.changed diagnostic res30: Hypertension
662H.00 Read hypertension treatm.stopped diagnostic res30: Hypertension
662O.00 Read on treatment for hypertension diagnostic res30: Hypertension
662P.00 Read hypertension monitoring diagnostic res30: Hypertension
662P000 Read hypertension 9 month review diagnostic res30: Hypertension
662q.00 Read trial reduction of antihypertensive therapy diagnostic res30: Hypertension
662r.00 Read trial withdrawal of antihypertensive therapy diagnostic res30: Hypertension
67H8.00 Read lifestyle advice regarding hypertension diagnostic res30: Hypertension
7Q01.00 Read high cost hypertension drugs diagnostic res30: Hypertension
7Q01y00 Read other specified high cost hypertension drugs diagnostic res30: Hypertension
8B26.00 Read antihypertensive therapy diagnostic res30: Hypertension
8BL0.00 Read patient on maximal tolerated antihypertensive therapy diagnostic res30: Hypertension
8CR4.00 Read hypertension clinical management plan diagnostic res30: Hypertension
8HT5.00 Read referral to hypertension clinic diagnostic res30: Hypertension
8I3N.00 Read hypertension treatment refused diagnostic res30: Hypertension
9h3..00 Read exception reporting: hypertension quality indicators diagnostic res30: Hypertension
9h31.00 Read excepted from hypertension qual indicators: patient unsuit diagnostic res30: Hypertension
9h32.00 Read excepted from hypertension qual indicators: informed dissent diagnostic res30: Hypertension
9N03.00 Read seen in hypertension clinic diagnostic res30: Hypertension
9N1y200 Read seen in hypertension clinic diagnostic res30: Hypertension
9N4L.00 Read dna - did not attend hypertension clinic diagnostic res30: Hypertension
9OI..00 Read hypertension monitoring admin. diagnostic res30: Hypertension
9OI1.00 Read attends hypertension monitor. diagnostic res30: Hypertension
9OI..11 Read hypertension clinic admin. diagnostic res30: Hypertension
9OI2.00 Read refuses hypertension monitor. diagnostic res30: Hypertension
9OI3.00 Read hyperten.monitor offer default diagnostic res30: Hypertension
9OI4.00 Read hypertens.monitor.1st letter diagnostic res30: Hypertension
9OI5.00 Read hypertens.monitor 2nd letter diagnostic res30: Hypertension
9OI6.00 Read hypertens.monitor 3rd letter diagnostic res30: Hypertension
9OI7.00 Read hypertens.monitor verbal inv. diagnostic res30: Hypertension
9OI8.00 Read hypertens.monitor phone invite diagnostic res30: Hypertension
9OI9.00 Read hypertens.monitor deleted diagnostic res30: Hypertension
9OIA.00 Read hypertension monitor.chck done diagnostic res30: Hypertension
9OIA.11 Read hypertension monitored diagnostic res30: Hypertension
9OIZ.00 Read hypertens.monitoring admin.nos diagnostic res30: Hypertension
F404200 Read blind hypertensive eye diagnostic res30: Hypertension
F421300 Read hypertensive retinopathy diagnostic res30: Hypertension
G2...00 Read hypertensive disease diagnostic res30: Hypertension
G20..00 Read essential hypertension diagnostic res30: Hypertension
G200.00 Read malignant essential hypertension diagnostic res30: Hypertension
G201.00 Read benign essential hypertension diagnostic res30: Hypertension
G20..11 Read high blood pressure diagnostic res30: Hypertension
G20..12 Read primary hypertension diagnostic res30: Hypertension
G202.00 Read systolic hypertension diagnostic res30: Hypertension
G203.00 Read diastolic hypertension diagnostic res30: Hypertension
G20z.00 Read essential hypertension nos diagnostic res30: Hypertension
G20z.11 Read hypertension nos diagnostic res30: Hypertension
G21..00 Read hypertensive heart disease diagnostic res30: Hypertension
G210.00 Read malignant hypertensive heart disease diagnostic res30: Hypertension
G210000 Read malignant hypertensive heart disease without ccf diagnostic res30: Hypertension
G210100 Read malignant hypertensive heart disease with ccf diagnostic res30: Hypertension
G210z00 Read malignant hypertensive heart disease nos diagnostic res30: Hypertension
G2...11 Read bp - hypertensive disease diagnostic res30: Hypertension
G211.00 Read benign hypertensive heart disease diagnostic res30: Hypertension
G211000 Read benign hypertensive heart disease without ccf diagnostic res30: Hypertension
G211100 Read benign hypertensive heart disease with ccf diagnostic res30: Hypertension
G211z00 Read benign hypertensive heart disease nos diagnostic res30: Hypertension
G21z.00 Read hypertensive heart disease nos diagnostic res30: Hypertension
G21z000 Read hypertensive heart disease nos without ccf diagnostic res30: Hypertension
G21z011 Read cardiomegaly - hypertensive diagnostic res30: Hypertension
G21z100 Read hypertensive heart disease nos with ccf diagnostic res30: Hypertension
G21zz00 Read hypertensive heart disease nos diagnostic res30: Hypertension
G22..00 Read hypertensive renal disease diagnostic res30: Hypertension
G220.00 Read malignant hypertensive renal disease diagnostic res30: Hypertension
G221.00 Read benign hypertensive renal disease diagnostic res30: Hypertension
G22..11 Read nephrosclerosis diagnostic res30: Hypertension
G222.00 Read hypertensive renal disease with renal failure diagnostic res30: Hypertension
G22z.00 Read hypertensive renal disease nos diagnostic res30: Hypertension
G22z.11 Read renal hypertension diagnostic res30: Hypertension
G23..00 Read hypertensive heart and renal disease diagnostic res30: Hypertension
G230.00 Read malignant hypertensive heart and renal disease diagnostic res30: Hypertension
G231.00 Read benign hypertensive heart and renal disease diagnostic res30: Hypertension
G232.00 Read hypertensive heart&renal dis wth (congestive) heart failure diagnostic res30: Hypertension
G233.00 Read hypertensive heart and renal disease with renal failure diagnostic res30: Hypertension
G234.00 Read hyperten heart&renal dis+both(congestv)heart and renal fail diagnostic res30: Hypertension
G23z.00 Read hypertensive heart and renal disease nos diagnostic res30: Hypertension
G24..00 Read secondary hypertension diagnostic res30: Hypertension
G240.00 Read secondary malignant hypertension diagnostic res30: Hypertension
G240000 Read secondary malignant renovascular hypertension diagnostic res30: Hypertension
G240z00 Read secondary malignant hypertension nos diagnostic res30: Hypertension
G241.00 Read secondary benign hypertension diagnostic res30: Hypertension
G241000 Read secondary benign renovascular hypertension diagnostic res30: Hypertension
G241z00 Read secondary benign hypertension nos diagnostic res30: Hypertension
G244.00 Read hypertension secondary to endocrine disorders diagnostic res30: Hypertension
G24z.00 Read secondary hypertension nos diagnostic res30: Hypertension
G24z000 Read secondary renovascular hypertension nos diagnostic res30: Hypertension
G24z100 Read hypertension secondary to drug diagnostic res30: Hypertension
G24zz00 Read secondary hypertension nos diagnostic res30: Hypertension
G25..00 Read stage 1 hypertension (nice - nat ins for hth clin excl 2011) diagnostic res30: Hypertension
G25..11 Read stage 1 hypertension diagnostic res30: Hypertension
G26..00 Read severe hypertension (nat inst for health clinical ex 2011) diagnostic res30: Hypertension
G26..11 Read severe hypertension diagnostic res30: Hypertension
G27..00 Read hypertension resistant to drug therapy diagnostic res30: Hypertension
G28..00 Read stage 2 hypertension (nice - nat ins for hth clin excl 2011) diagnostic res30: Hypertension
G2y..00 Read other specified hypertensive disease diagnostic res30: Hypertension
G2z..00 Read hypertensive disease nos diagnostic res30: Hypertension
G672.00 Read hypertensive encephalopathy diagnostic res30: Hypertension
G672.11 Read hypertensive crisis diagnostic res30: Hypertension
Gyu2.00 Read [x]hypertensive diseases diagnostic res30: Hypertension
Gyu2000 Read [x]other secondary hypertension diagnostic res30: Hypertension
Gyu2100 Read [x]hypertension secondary to other renal disorders diagnostic res30: Hypertension
L122.00 Read other pre-existing hypertension in preg/childbirth/puerp diagnostic res30: Hypertension
L122000 Read other pre-existing hypertension in preg/childb/puerp unspec diagnostic res30: Hypertension
L122100 Read other pre-existing hypertension in preg/childb/puerp - deliv diagnostic res30: Hypertension
L122300 Read other pre-exist hypertension in preg/childb/puerp-not deliv diagnostic res30: Hypertension
L122z00 Read other pre-existing hypertension in preg/childb/puerp nos diagnostic res30: Hypertension
L127.00 Read pre-eclampsia or eclampsia with pre-existing hypertension diagnostic res30: Hypertension
L127z00 Read pre-eclampsia or eclampsia + pre-existing hypertension nos diagnostic res30: Hypertension
L128.00 Read pre-exist hypertension compl preg childbirth and puerperium diagnostic res30: Hypertension
L128000 Read pre-exist hyperten heart dis compl preg childbth+puerperium diagnostic res30: Hypertension
L128200 Read pre-exist 2ndry hypertens comp preg childbth and puerperium diagnostic res30: Hypertension
TJC7.00 Read adverse reaction to other antihypertensives diagnostic res30: Hypertension
TJC7z00 Read adverse reaction to antihypertensives nos diagnostic res30: Hypertension
U60C500 Read [x]oth antihyperten drug caus advers eff in therap use, nec diagnostic res30: Hypertension
U60C511 Read [x] adverse reaction to other antihypertensives diagnostic res30: Hypertension
U60C51A Read [x] adverse reaction to antihypertensives nos diagnostic res30: Hypertension
I10 ICD-10 essential (primary) hypertension diagnostic res30: Hypertension
I11 ICD-10 hypertensive heart disease diagnostic res30: Hypertension
I11.0 ICD-10 hypertensive heart disease with (congestive) heart failure diagnostic res30: Hypertension
I11.9 ICD-10 hypertensive heart disease without (congestive) heart failure diagnostic res30: Hypertension
I12 ICD-10 hypertensive renal disease diagnostic res30: Hypertension
I12.0 ICD-10 hypertensive renal disease with renal failure diagnostic res30: Hypertension
I12.9 ICD-10 hypertensive renal disease without renal failure diagnostic res30: Hypertension
I13 ICD-10 hypertensive heart and renal disease diagnostic res30: Hypertension
I13.0 ICD-10 hypertensive heart and renal disease with (congestive) heart failure diagnostic res30: Hypertension
I13.1 ICD-10 hypertensive heart and renal disease with renal failure diagnostic res30: Hypertension
I13.2 ICD-10 hypertensive heart and renal disease with both (congestive) heart failure and renal failure diagnostic res30: Hypertension
I13.9 ICD-10 hypertensive heart and renal disease, unspecified diagnostic res30: Hypertension
I15 ICD-10 secondary hypertension diagnostic res30: Hypertension
I15.0 ICD-10 renovascular hypertension diagnostic res30: Hypertension
I15.1 ICD-10 hypertension secondary to other renal disorders diagnostic res30: Hypertension
I15.2 ICD-10 hypertension secondary to endocrine disorders diagnostic res30: Hypertension
I15.8 ICD-10 other secondary hypertension diagnostic res30: Hypertension
I15.9 ICD-10 secondary hypertension, unspecified diagnostic res30: Hypertension
I67.4 ICD-10 hypertensive encephalopathy diagnostic res30: Hypertension

0 comments have been posted.

Please log in to leave a comment.

Quick links:

Code list links:

Only the original uploading author or an administrator can add, edit or delete this article and its associated codes.

University of Manchester IPH ClinicalCodes is a project at the University of Manchester Institute of Population Health

Funded by NIHR School for Primary Care The ClinicalCodes project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR)

© 2013-2014 University of Manchester all rights reserved