A 79-year-old man in a care home is found to have a creatinine rise from 100 to 180 micromol/L over 48 hours. He has been taking Ramipril and Ibuprofe...

Question

A 79-year-old man in a care home is found to have a creatinine rise from 100 to 180 micromol/L over 48 hours. He has been taking Ramipril and Ibuprofen for osteoarthritis, and has been vomiting with poor oral intake. Blood pressure is 90/60 mmHg. What is the most appropriate initial management?

Accepted Answer

Stop Ramipril and NSAIDs and give intravenous 0.9% saline

Answer

Increase Ramipril dose to improve renal perfusion

Answer

Continue Ibuprofen to treat pain

Answer

Withhold fluids and monitor for spontaneous recovery

Answer

Start loop diuretics to increase urine output

uk-plab-1 MCQ (SBA): Acute kidney injury – pre-renal

A 79-year-old man in a care home is found to have a creatinine rise from 100 to 180 micromol/L over 48 hours. He has been taking Ramipril and Ibuprofen for osteoarthritis, and has been vomiting with poor oral intake. Blood pressure is 90/60 mmHg. What is the most appropriate initial management?