Pettit Natalie, Benken Jamie, Valdepeñas Benito, Gandhi Nishita, Alyousef Rama, Benken Scott
Retzky College of Pharmacy, University of Illinois, Chicago, IL 60612, USA.
Biomedicines. 2025 Jun 12;13(6):1442. doi: 10.3390/biomedicines13061442.
: The use of angiotensin II (AT2S) as a vasopressor in patients receiving angiotensin receptor blockers (ARBs) prior to kidney transplant (KT) raises theoretical concerns. At our center, AT2S is the first-line vasopressor during KT. This study evaluated the hemodynamic and clinical effects of pre-transplant ARBs on AT2S use in KT. : This single-center, retrospective cohort trial included patients with hypertension ≥ 18 years old on antihypertensive therapy who received AT2S as the first-line vasopressor peri-transplant. Patients were divided into ARB and non-ARB cohorts. Primary outcomes included total AT2S duration, time with SBP < 120 mmHg, and need for additional vasopressor support. : A total of 65 patients were analyzed: 22 in the ARB group and 43 in the non-ARB group. There were no significant differences in the frequency or duration of SBP < 120 mmHg or additional vasopressor requirements between groups ( > 0.05). Hospital and ICU stay length, safety, and adverse drug events were also similar. : Contrary to theoretical concerns and observations in other distributive shock populations, no significant hemodynamic or clinical differences were observed in the response to AT2S in patients with pre-transplant ARB use.
在肾移植（KT）前接受血管紧张素受体阻滞剂（ARB）治疗的患者中，使用血管紧张素II（AT2S）作为血管升压药引发了理论上的担忧。在我们中心，AT2S是KT期间的一线血管升压药。本研究评估了移植前ARB对KT中AT2S使用的血流动力学和临床影响。：这项单中心回顾性队列试验纳入了年龄≥18岁、接受抗高血压治疗且在移植围手术期接受AT2S作为一线血管升压药的高血压患者。患者被分为ARB组和非ARB组。主要结局包括AT2S总使用时长、收缩压（SBP）<120 mmHg的时长以及是否需要额外的血管升压药支持。：共分析了65例患者：ARB组22例，非ARB组43例。两组之间SBP<120 mmHg的频率或时长以及额外血管升压药需求方面无显著差异（P>0.05）。住院和重症监护病房（ICU）住院时长、安全性及药物不良事件也相似。：与理论担忧及其他分布性休克人群中的观察结果相反，在移植前使用ARB的患者中，对AT2S的反应未观察到显著的血流动力学或临床差异。
