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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The ideal management of renin-angiotensin-aldosterone system (RAAS) inhibitors following the onset of acute kidney injury (AKI) remains a topic of debate. Despite being routinely discontinued in clinical settings, the evidence supporting this practice is very limited. This study aims to determine whether continuation versus discontinuation of RAAS inhibitors during AKI is associated with differences in patient outcomes.
This retrospective cohort study utilized the MIMIC-IV database (v3.1) and included 5,259 adult patients with hospital-acquired AKI and pre-admission RAAS inhibitor use. Patients were categorized based on whether RAAS inhibitor therapy was continued or held within 48 hours of AKI diagnosis. The primary outcomes were in-hospital mortality and ICU admission. Analyses were adjusted for demographics, comorbidities, baseline creatinine, and AKI severity via multivariable logistic regression.
Of the 5,259 patients, 2,196 (41.8%) continued RAAS inhibitors. Continuation was associated with significantly lower in-hospital mortality (1.3% vs 4.8%; adjusted odds ratio [aOR] 0.27, 95% CI: 0.07–1.00, p<0.05) and reduced ICU admission (16.1% vs 25.7%; aOR 0.52, 95% CI: 0.28–1.00, p<0.05). The number needed to treat (NNT) was 29 to prevent one death and 10 to prevent one ICU admission. The continuation group also had shorter hospital length of stay (5.1 vs 7.8 days, p<0.001) and a higher rate of creatinine recovery by discharge (65.0% vs 55.0%, p<0.001), with no increased risk of dialysis.
Figure 1. In-hospital survival by RAAS inhibitor management strategy in patients with acute kidney injury. Kaplan-Meier curves demonstrate significantly higher survival in patients who continued RAAS inhibitors compared to those who discontinued. HR 0.26 (95% CI: 0.17-0.39), log-rank p<0.001. Numbers at risk are displayed below the curves.
Among patients who develop AKI, continuation of RAAS inhibitors was associated with substantially lower mortality and ICU admission rates, providing evidence against the routine discontinuation of these medications upon AKI diagnosis. These findings suggest that a fundamental shift towards individualized continuation strategies in hemodynamically stable patients is necessary.
