Table 2.
Number of events, incidence rates, crude and adjusted HRs, and weighted ARDs for the association between stopping versus continuing RASi and adverse outcomes
| N | Events | Py | Incidence rate per 100 py | Crude HR (95% CI) | OW adjusted HRa (95% CI) | Absolute risk (95% CI) | ARD (95% CI) | |
|---|---|---|---|---|---|---|---|---|
| Primary outcome: composite of death, MI and stroke | ||||||||
| Overall | 10 165 | 5633 | 25 872 | 21.8 (21.2–22.3) | ||||
| Continued RASi | 5736 | 3020 | 15 257 | 19.8 (19.1–20.5) | 1 (Reference) | 1 (Reference) | 62.6 (61.1–64.0) | |
| Stopped RASi | 4429 | 2613 | 10 614 | 24.6 (23.7–25.6) | 1.23 (1.17–1.30) | 1.13 (1.07–1.19) | 66.3 (64.6–67.9) | 3.7 (2.6, 4.8) |
| Secondary outcome: recurrent AKI | ||||||||
| Overall | 10 165 | 1332 | 25 815 | 5.2 (4.9–5.4) | ||||
| Continued RASi | 5736 | 780 | 15 195 | 5.1 (4.8–5.5) | 1 (Reference) | 1 (Reference) | 20.7 (19.2–22.1) | |
| Stopped RASi | 4429 | 552 | 10 620 | 5.2 (4.8–5.7) | 1.00 (0.90–1.11) | 0.94 (0.84–1.05) | 20.4 (18.7–22.2) | −0.2 (−1.4, 0.9) |
| Positive control outcome: moderate hyperkalaemia | ||||||||
| Overall | 9147 | 1530 | 21 788 | 7.0 (6.7–7.4) | ||||
| Continued RASi | 5161 | 943 | 12 703 | 7.4 (7.0–7.9) | 1 (Reference) | 1 (Reference) | 27.2 (25.5–28.9) | |
| Stopped RASi | 3986 | 587 | 9085 | 6.5 (5.9–7.0) | 0.86 (0.77–0.95) | 0.79 (0.71–0.88) | 23.6 (21.6–25.6) | −3.6 (−5.0, −2.3) |
| Tertiary outcomes: HHF and progression of CKD | ||||||||
| HHF | ||||||||
| Overall | 10 165 | 4245 | 20 624 | 20.6 (20.0–21.2) | ||||
| Continued RASi | 5736 | 2474 | 12 090 | 20.5 (19.7–21.3) | 1 (Reference) | 1 (Reference) | 52.5 (50.9–54.2) | |
| Stopped RASi | 4429 | 1771 | 8533 | 20.8 (19.8–21.7) | 0.98 (0.93–1.05) | 1.01 (0.94–1.07) | 53.3 (51.4–55.3) | 0.8 (−0.5, 2.1) |
| Progression of CKD | ||||||||
| Overall | 9147 | 1999 | 20 665 | 9.7 (9.3–10.1) | ||||
| Continued RASi | 5161 | 1116 | 12 268 | 9.1 (8.6–9.6) | 1 (Reference) | 1 (Reference) | 30.2 (28.5–31.9) | |
| Stopped RASi | 3986 | 883 | 8396 | 10.5 (9.8–11.2) | 1.11 (1.02–1.22) | 1.05 (0.96–1.15) | 31.4 (29.3–33.4) | 1.2 (−0.2, 2.5) |
py, person-years; HR, hazard ratio; CI, confidence interval; OW, overlap weights; ARD, absolute risk difference; RASi, renin–angiotensin system inhibitors; AKI, acute kidney injury; CKD, chronic kidney disease.
Adjusted for age, age categories, sex, education, eGFR at admission, eGFR category at admission, medical history of diabetes, hypertension, MI, arrhythmia, cerebrovascular disease, peripheral vascular disease, ischaemic heart disease, chronic obstructive pulmonary disease, cancer, liver disease, chronic heart failure, dyslipidaemia, hypothyroidism, extracranial haemorrhage, and valvular heart disease, use in the year prior to admission of beta blockers, calcium channel blockers, loop diuretics, thiazide diuretics, potassium-sparing diuretics, NSAIDs, antilipids, alpha blockers, nitrate, mineralocorticoid receptor antagonists, hydralazine, antiarrhythmics, digoxin, anticoagulants, diabetes medication and opioids, health care access in the year prior in primary care context, specialist care context and hospitalizations, primary cause of admission, complications during admission (i.e. sepsis, cardiac surgery, cardiac catheterization, abdominal aortic aneurysm repair, pneumonia, liver failure, acute MI and non-cardiac surgery) and characteristics of admission including duration of stay, AKI as cause of admission, stage of AKI according to KDIGO and average and peak creatinine during hospitalization.