Question

A 72-year-old man in hospital for pneumonia develops an acute rise in creatinine from 90 µmol/L to 210 µmol/L over 48 hours. He has been taking Ramipril and regular Ibuprofen for osteoarthritis, and his blood pressure is now 92/58 mmHg. Urine output has fallen. What is the most appropriate immediate management?

Accepted Answer

Stop Ramipril and NSAIDs, give an intravenous fluid bolus and monitor urine output closely

Answer

Continue Ramipril and Ibuprofen to maintain blood pressure

Answer

Restrict fluids to prevent fluid overload

Answer

Start high-dose loop diuretics

Answer

Insert a long-term urinary catheter and discharge

Practice question