Why do ACE inhibitors cause AKI?
During ACEI initiation, renal dysfunction can occur due to a drop in renal perfusion pressure and subsequent decrease in glomerular filtration. This is attributed to the drug’s preferential vasodilation of the renal efferent arteriole, which impairs the kidney’s ability to compensate for low perfusion states.
What should not be given with NSAIDs?
Drug interactions with NSAIDs When combined with blood-thinning medicines (such as warfarin) NSAIDs increase the risk of bleeding. NSAIDs can cause kidney failure when they are combined with ACE inhibitors (medicines used to treat heart problems and high blood pressure) and diuretics (medicines to remove excess fluid).
Which NSAID is best for hypertension?
Aspirin is also an NSAID, but experts think that it’s safer for people with hypertension. Acetaminophen — the active ingredient in Tylenol — is a different type of painkiller that doesn’t raise blood pressure as a side effect.
Is paracetamol an NSAID?
Paracetamol (acetaminophen) is generally not considered an NSAID because it has only minor anti-inflammatory activity. Paracetamol treats pain mainly by blocking COX-2 and inhibiting endocannabinoid reuptake almost exclusively within the brain, but not much in the rest of the body.
Which drugs are most nephrotoxic?
Drugs most often associated with this pathogenic mechanism of nephrotoxicity include antiplatelet agents (e.g., clopidogrel [Plavix], ticlopidine [Ticlid]), cyclosporine, mitomycin-C (Mutamycin), and quinine (Qualaquin).
Is Lasix nephrotoxic?
High-dose treatment of both LASIX and these other drugs may result in elevated serum levels of these drugs and may potentiate their toxicity as well as the toxicity of LASIX. LASIX can increase the risk of cephalosporin-induced nephrotoxicity even in the setting of minor or transient renal impairment.
Which drugs should be stopped in AKI?
Clinicians managing patients with AKI therefore frequently stop drugs that lower blood pressure (particularly ACEI and ARBs, which selectively reduce glomerular pressure) and diuretics. ACEIs, ARBs and potassium-sparing diuretics may also be stopped because of hyperkalaemia.
Does metformin cause AKI?
Using time-updated medication data, they did not find an association between metformin and AKI. However, patients that had ‘ever’ used metformin had a 1.3-fold higher risk of AKI than those who had ‘never’ used metformin.
Which NSAIDs do not raise blood pressure?
Naproxen (Naprosyn) does not increase the risk of hypertension or stroke. Celecoxib (Celebrex) does not increase the risk of hypertension or stroke.
Is Metformin a nephrotoxic drug?
Metformin itself is not a nephrotoxic drug. Initially appointed as the safest hypoglycemic agent in chronic kidney disease, its use has been limited in these patients because of the perceived risk of lactic acidosis.
Why is metformin held in AKI?
Metformin is not nephrotoxic, but 90% is excreted by the kidneys. Thus, it does not cause AKI but metformin will accumulate in AKI.
Do you stop furosemide in AKI?
The recent SPARK study16 which studied the effect of low-dose furosemide in critically ill patients with AKI concluded that furosemide did not prevent worsening AKI, did not reduce RRT use, nor did it improve kidney recovery. Moreover its use was associated with more minor electrolyte abnormalities.