A large retrospective study challenges standard medical practice by showing that discontinuing renin-angiotensin system inhibitors after acute kidney function decline actually increases patient risks.
Researchers analyzed over 4,200 adults in Manitoba, Canada, who began RAS inhibitor therapy between 2008 and 2021. One-third of patients who experienced more than 15% eGFR drop within 90 days discontinued therapy, while two-thirds continued treatment.
Results showed patients who stopped therapy faced 74% higher risk of end-stage kidney disease and 23% higher mortality risk compared to those continuing treatment. No significant differences emerged in cardiovascular events or acute kidney injury between groups.
The findings suggest immediate eGFR declines may represent hemodynamic changes rather than true kidney injury, questioning routine medication cessation practices.