Medicine, cilt.105, sa.13, ss.1-6, 2026 (Hakemli Dergi)
Abstract Background: There are many causes of acute kidney injury after cardiac surgery. Activation of the renin-angiotensin system is one of the most important mechanisms. In this article, we investigated the effect of angiotensin-converting enzyme (ACE) inhibitor treatment on renal damage in cardiac surgery. Methods: Six hundred twelve patients undergoing cardiac surgery were divided into 2 groups. The patients in group I were 319 patients who used ACE inhibitors before the operation. The patients in Group II consisted of 293 patients who did not use ACE inhibitors. In addition to blood renal parameters and the need for dialysis, length of hospital stay, hospital costs, and readmission rates were evaluated between the 2 groups. In addition to the early-term results, the patients were followed for 2 years for renal destruction. Results: Dialysis was needed in 9 patients in Group I. Hemodialysis was required in 31 of the Group II patients. In addition, the increase in creatinine and blood urea nitrogen levels and the decrease in glomerular filtration rate and creatinine clearance were higher in Group II patients (P <.05). The length of stay in the intensive care unit and hospitalization were statistically significantly higher in Group II patients. In addition, hospital costs and re-hospitalizations were statistically significantly lower in the treatment group. Conclusion: The use of ACE inhibitors before cardiac surgery is effective in preserving renal function in the postoperative period, and these results are important in achieving acceptable and favorable outcomes for patients and the hospital in the postoperative period. Abbreviations: ACE = angiotensin-converting enzyme, AKI = acute kidney injury, AKIN = AKI network, BUN = blood nitrogen urea, CABG = coronary artery bypass graft, CPB = cardiopulmonary bypass, Cr = creatinine, CrCL = creatinine clearance, ECMO = extracorporeal membrane oxygenation, IABP = intra-aortic balloon pump, ICU = intensive care unit, IMA = internal mammarian artery, KDIGO = kidney disease improving global outcomes, RIFLE = risk, injury, failure, loss, and end-stage renal disease.