QuestionSBA
QuestionChoice
Naproxen is another NSAID medication and could further impair this patient's renal function. It is better to stop ibuprofen entirely than to switch it to naproxen.
10002355
d
Switch ibuprofen to naproxen
QuestionChoice
This patient is presenting with signs characteristic of an acute kidney injury (AKI), given the rise in serum creatinine over a short period of time, as well as the oliguria. One of the key steps in managing acute kidney injury is to stop any nephrotoxic medications. Non-steroidal anti-inflammatory agents like ibuprofen can contribute towards AKIs and should therefore be stopped in this patient.
10002352
a
Stop ibuprofen
QuestionChoice
Statins are less likely to be nephrotoxic and therefore are not usually stopped in acute kidney injury.
10002353
b
Stop atorvastatin
QuestionChoice
Dialysis would be considered in refractory cases of acute kidney injury where other treatment options have failed. The first step in this scenario is to stop any nephrotoxic medications.
10002354
c
Start dialysis
QuestionChoice
Statins are less likely to be nephrotoxic and therefore are not usually stopped in acute kidney injury.
10002356
e
Switch atorvastatin to ezetimibe
Concept
Chapter
2693
3752
Acute Kidney Injury
Topic
142
Nephrology
13017
A 76-year-old male is admitted to the hospital following a fractured neck of femur. He has a past medical history of osteoarthritis and hypercholesterolaemia for which he is taking ibuprofen and atorvastatin. Two days after being admitted, the patient's serum creatinine rises from 74 micromol/l to 165 micromol/l (normal range 60-120 micromol/l). He also develops peripheral oedema and is passing less urine than usual.


Which of the following management steps should be considered first?
a