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Critical Care

Open Access

Preoperative therapy with angiotensin-converting enzyme inhibitors in cardiac surgery patients: is there any impact on postoperative renal function?

  • F Ampatzidou1,
  • M Sileli1,
  • K Diplaris1,
  • C Koutsogiannidis1,
  • T Karaiskos1 and
  • G Drossos1
Critical Care201418(Suppl 1):P188

Published: 17 March 2014


Preoperative therapy with angiotensin-converting enzyme inhibitors (ACEI) is common in patients undergoing cardiac surgery. The aim of this study was to evaluate the still-debated impact of preoperative use of ACEI on postoperative renal function in cardiac surgery patients [1],[2].


A total of 624 consecutive patients, who underwent cardiac surgery from July 2012 to October 2013, were evaluated. Data were prospectively collected in our clinic's electronic database and were retrospectively analyzed as to preoperative ACEI therapy. The chi- square test was used for correlations. Endpoints of the study were the development of postoperative acute kidney injury (AKI) and the difference between hospital admission and discharge glomerular filtration rate (GFR). The AKI definition was based on modified RIFLE classification. GFR values were estimated by the MDRD formula.


A total of 354 patients (56.7%) were treated with ACEI preoperatively. Overall, 95 patients (15.3%) developed postoperative AKI. Preoperative use of ACEI was not associated with the development of postoperative AKI (P = 0.981). Mean GFR values on admission day were 65.23 ± 16.89 for ACEI users, and 65.06 ± 19.62 for the rest of the cohort. Mean GFR values on discharge day were 66.77 ± 21.25 and 67.35 ± 25.64 respectively. The difference in GFR at the time of hospital admission and on discharge day had no statistical difference, P = 0.511 (Table 1). Overall, 25 patients (4%) needed dialysis.
Table 1

AKI and GFR difference


ACEI users (n= 354)

ACEI nonusers (n= 270)

P value


54 (15.3%)

41 (15.2%)


GFR difference (mean)

+ 1.43




The impact of preoperative ACEI treatment on postoperative renal function after cardiac surgery is still debated. We found no association, neither protective nor harmful, between preoperative ACEI therapy and renal function impairment.

Authors’ Affiliations

General Hospital 'G. Papanikolaou, Thessaloniki, Greece


  1. Arora P, et al.: Clin J Am Soc Nephrol. 2008, 3: 1266-1273. 10.2215/CJN.05271107PubMed CentralView ArticlePubMedGoogle Scholar
  2. Ouzounian M, et al.: Ann Thorac Surg. 2012, 93: 559-564. 10.1016/j.athoracsur.2011.10.058View ArticlePubMedGoogle Scholar


© Ampatzidou et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.