During vomiting, diarrhoea or fever with poor intake, several common drugs raise the risk of acute kidney injury or its complications. These include ACE inhibitors and ARBs, diuretics, SGLT2 inhibitors, metformin and NSAIDs.
Written advice to pause these temporarily during dehydrating illness, and to restart once eating and drinking normally for 24 to 48 hours, helps patients act early. The advice should name the patient's own drugs and say when to seek a blood test.
- List the patient's own drugs to pause during dehydrating illness.
- Include ACE inhibitors, ARBs, diuretics, SGLT2 inhibitors, metformin and NSAIDs where prescribed.
- Tell patients to restart once eating and drinking normally for 24 to 48 hours.
- Advise a creatinine check if illness lasts more than a couple of days.
Why it matters
Many episodes of acute kidney injury in CKD start with a short illness at home and a full set of tablets.
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