Question

A 70-year-old man with sepsis from pneumonia develops a creatinine rise from 80 to 240 µmol/L over 48 hours, oliguria and hyperkalaemia. He is on Ramipril and Ibuprofen. What is the most appropriate immediate management?

Accepted Answer

Stop nephrotoxic and renally excreted drugs, optimise fluid status and treat sepsis

Answer

Continue Ramipril to protect kidneys

Answer

Start high-dose diuretics without assessing volume status

Answer

Delay treatment until ultrasound kidneys is done

Answer

No change; this is expected in sepsis

Practice question

A 70-year-old man with sepsis from pneumonia develops a creatinine rise from 80 to 240 µmol/L over 48 hours, oliguria and hyperkalaemia. He is on Ramipril and Ibuprofen. What is the most appropriate immediate management?