A large share of CKD progression and acute kidney injury is iatrogenic and preventable at the point of prescribing.
In anyone with a reduced eGFR, avoid NSAIDs — including over-the-counter and combination analgesics — use iodinated contrast only when it will change management and attend to hydration, and dose-adjust renally cleared drugs, reviewing the list at each visit. Apply sick-day rules: hold RAAS blockers and SGLT2 inhibitors during acute volume-depleting illness, and check potassium and renal function after any change.
- Avoid NSAIDs, including over-the-counter and combination analgesics, in reduced eGFR.
- Use iodinated contrast only when it changes management, with attention to hydration.
- Dose-adjust renally cleared drugs and review the medication list at every visit.
- Apply sick-day rules: hold RAAS blockers and SGLT2 inhibitors during acute volume-depleting illness.
Why it matters
Much CKD progression and acute kidney injury is iatrogenic and preventable at the point of prescribing.
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