During an illness that causes dehydration, such as vomiting, diarrhoea or fever with poor intake, several common drugs raise the risk of acute kidney injury or other harm. Patients with CKD should know to pause ACE inhibitors or ARBs, diuretics, metformin, SGLT2 inhibitors and NSAIDs until they are eating and drinking normally for 24 to 48 hours, and to seek advice if the illness persists.
- Give patients with CKD a written list of medicines to pause during dehydrating illness.
- Include ACE inhibitors or ARBs, diuretics, metformin, SGLT2 inhibitors and NSAIDs.
- Restart once eating and drinking normally for 24 to 48 hours.
- Check creatinine and potassium if the illness lasts more than a couple of days.
Why it matters
Many episodes of acute kidney injury in CKD start at home during a minor illness.
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