A 68-year-old woman is admitted with acute kidney injury after starting an NSAID while on ramipril and a thiazide diuretic. She is mildly dehydrated w...

Question

A 68-year-old woman is admitted with acute kidney injury after starting an NSAID while on ramipril and a thiazide diuretic. She is mildly dehydrated with creatinine rising from 90 µmol/L baseline to 220 µmol/L. There is no obstruction on ultrasound. What is the most appropriate initial management?

Accepted Answer

Stop the NSAID and ACE inhibitor, correct volume depletion and monitor renal function

Answer

Continue all current medications and observe

Answer

Commence high-dose intravenous frusemide

Answer

Start renal replacement therapy immediately

Answer

Perform renal biopsy urgently

au-amc MCQ (SBA): Acute kidney injury from triple whammy