Abstract
Answer E. Stop ramipril
In this case, the patient has an acute kidney injury (AKI) from volume depletion secondary to dehydration. It is important that assessment of a patient with AKI includes a medication review. Angiotensin-converting enzyme inhibitors reduce blood flow to the kidney and can exacerbate kidney injury. This medication should be withheld at the time of suspected injury pending blood results and stopped once blood test results confirm AKI. The other drugs listed are not contraindicated in this situation and can be continued. Drugs that are contraindicated in AKI include all non-steroidal anti-inflammatories, diuretics, metformin, digoxin, lithium and opioids.
InnovAiT article: Acute kidney injury. DOI: