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December 8, 2025BloodOpen Access

Impact of angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) on kidney functions in allogeneic stem cell transplant patients receiving tacrolimus

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Authors

SJSaad Javaid

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Overview

Retrospective analysis finds ACE inhibitors increase AKI and proteinuria risk in stem cell transplant patients receiving tacrolimus, suggesting careful medication consideration.

Key Points

  • Evaluate the incidence of acute kidney injury and renal complications in patients receiving ACE inhibitors or ARBs alongside tacrolimus after allogeneic stem cell transplantation.
  • Retrospective analysis using TriNetX Research Network data from cancer patients aged 18+ from 2015-2024
  • Patients categorized into groups based on ACE inhibitor/ARB usage with tacrolimus
  • Outcomes evaluated at six months post-transplant, including acute kidney injury and proteinuria
  • Cohorts matched using 1:1 propensity score for balanced comparisons
  • 3,100 patients received ACE inhibitors or ARBs, while 10,211 did not
  • Higher incidence of AKI in the ACE inhibitor/ARB group (35% vs. 31%, p = 0.0342)
  • Increased proteinuria prevalence with ACE inhibitors/ARBs (25% vs. 17%, p < 0.0001)
  • Slightly lower renal replacement therapy need in ACE inhibitor/ARB group (3.4% vs. 4.0%, p = 0.0697)
  • Reduced left ventricular ejection fraction at six months in ACE inhibitor/ARB group (56% vs. 58%, p = 0.0307)

Cite This Study

Saad Javaid (2025) studied this question.

synapsesocial.com/papers/69362f7f4fa91c937236e516https://doi.org/10.1182/blood-2025-2503
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Also Consider

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

  1. 1Elevated tacrolimus exposure variability predicts transplant renal insufficiency2026 · 2 citations
  2. 2Impact 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 malignancies2025
  3. 3A Five‐Year Prospective, Randomized, Open‐Label Study of Standard‐Dose Versus Low‐Dose Prolonged‐Release Tacrolimus With or Without Angiotensin‐Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Post Kidney Transplantation2024
  4. 4Preliminary Evaluation of Tacrolimus Impact on Glycemic Control, Renal Function, and Hematological Inflammatory Markers in Kidney Transplant Recipients2025 · 1 citations
  5. 5Effect of early post-hematopoietic stem cell transplant tacrolimus concentration on transplant outcomes in pediatric recipients: One facility’s ten-year experience of immunosuppression with tacrolimus2024 · 6 citations