Festive flu delay . . . and other storiesBMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j54 (Published 12 January 2017) Cite this as: BMJ 2017;356:j54
All rapid responses
We are delighted that you chose to cover our paper (Mansfield KE, Nitsch D, Smeeth L, et al. Prescription of Renin-Angiotensin System Blockers and Risk of Acute Kidney Injury: A Population-Based Cohort Study. BMJ Open 2016;6:1–20. doi:10.1136/bmjopen-2016-012690) in Minerva (Antihypertensives and acute kidney injury, BMJ 2017;356:j54 doi: 10.1136/bmj.j54).
However, we are very concerned that you have misunderstood our findings. You state that, “for patients with known stage 4 chronic kidney disease, prescribing renin-angiotensin system inhibitors increased the risk of acute kidney injury by a factor of 6-8 times”; THIS IS NOT THE CASE. Our findings showed that, compared to those without chronic kidney disease, for those with stage 4 chronic kidney disease the risk of acute kidney injury was increased by a factor of 6-8 times. As you stated, overall the risk of AKI was 1.12 (95% CI 1.07 to 1.17) times greater during time exposed to renin-angiotensin system blockers. In those with stage 4 chronic kidney disease, the rate of acute kidney injury was actually reduced during time exposed to a renin-angiotensin system blocker compared to time exposed to other antihypertensive drugs (incidence rate ratio 0.66, 95% CI 0.44-0.97) (Figure 2).
Given the wide readership of this column in the print BMJ, and the clinical importance of this error, we would be grateful if you could print a correction.
Competing interests: No competing interests