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December 8, 2025BloodOpen Access

Impact of angiotensin converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARB) on tumor lysis syndrome, acute kidney injury, and rasburicase use in patients undergoing chemotherapy for hematologic malignancies

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Authors

EPEmily Pack

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Overview

Observational study shows ACEi/ARB use increases tumor lysis syndrome and acute kidney injury in hematologic malignancies, indicating careful monitoring is needed.

Key Points

  • To examine the effects of ACE inhibitors and angiotensin receptor blockers on tumor lysis syndrome and acute kidney injury in patients with hematologic malignancies.
  • Used the TriNetX Research Network to identify patients aged 18+ with hematologic malignancies undergoing chemotherapy.
  • Divided patients into those receiving ACEis/ARBs and those who did not within 30 days of chemotherapy initiation.
  • Conducted propensity score matching to balance characteristics between the two groups.
  • Assessed incidents of tumor lysis syndrome, acute kidney injury, and rasburicase use in the matched cohorts.
  • 1.9% of patients in the ACEi/ARB group developed tumor lysis syndrome compared to 1.3% in the control group (RR 1.5).
  • 7.8% of patients in the ACEi/ARB group experienced acute kidney injury compared to 5.0% in the control group (RR 1.6).
  • Rasburicase use was 3.1% in the ACEi/ARB group versus 2.2% in the control group (RR 1.4).

Cite This Study

Emily Pack (2025) studied this question.

synapsesocial.com/papers/69362f3d4fa91c937236d4ebhttps://doi.org/10.1182/blood-2025-4527
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Retrospective Cohort Study Evaluating the Association Between Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use and Tyrosine Kinase Inhibitor-Associated Toxicity in Advanced Renal Cell Carcinoma2026
  2. 2Impact of angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) on kidney functions in allogeneic stem cell transplant patients receiving tacrolimus2025
  3. 3Comparative effectiveness of antihypertensive drug classes in patients with gastrointestinal malignancy and incident hypertension.2026
  4. 4Impact of ACEI/ARB use on the survival of hypertensive patients with cancer: A meta‑analysis2024 · 2 citations
  5. 5A comparative analysis of ACE Inhibitors and ARBs as cancer risk factors2026