Question

A 76-year-old woman is admitted with progressive confusion and reduced urine output. She has been taking Ramipril, Ibuprofen and Furosemide for heart failure and osteoarthritis. Blood tests show: creatinine 260 µmol/L (baseline 110), urea 18 mmol/L, potassium 5.9 mmol/L. She is clinically hypovolaemic. What is the most appropriate immediate management of her renal function and medications?

Accepted Answer

Stop Ramipril, NSAIDs and diuretics, give IV fluids and treat hyperkalaemia urgently

Answer

Continue all medications and give a fluid bolus

Answer

Stop only the diuretic and increase Ramipril

Answer

Start high-dose IV steroids and continue current medications

Answer

Delay any changes until a renal biopsy is performed

Practice question