Strong international collaboration results in two articles in the BMJ

Department of Clinical Epidemiology has a strong collaboration with London School of Hygiene and Tropical Medicine – one of the most tradition-bound epidemiology units in the world. This collaboration recently resulted in two articles published in the BMJ. The topic of the articles is monitoring creatinine levels after initiation of treatment with a particular type of medication to regulate blood pressure (the so-called ACE inhibitors). The results show that surprisingly few patients have these blood samples taken when the treatment is initiated. More importantly, the studies show that having a high level of creatinine increases the risk of an adverse long-term outcome in terms of chronic kidney disease, heart disease or death. The studies also show that increases in creatinine below 30%, which has so far been the boundary for ceasing treatment, also have significant impact – a novel result. The studies are carried out by Morten Schmidt who has had a six month research stay at London School of Hygiene and Tropical Medicine. Schmidt M, Mansfield KE, Bhaskaran K, et al. Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ 2017;j791. Schmidt M, Mansfield KE, Bhaskaran K, et al. Adherence to guidelines for creatinine and potassium monitoring and discontinuation following renin–angiotensin system blockade: a UK general practice-based cohort study. BMJ Open 2017;7:e012818