Описание
NSAIDs reduce the antihypertensive and renoprotective efficacy of ACE inhibitors and can precipitate acute kidney injury, particularly in volume-depleted or elderly patients.
Механизм
Ibuprofen inhibits renal prostaglandin synthesis, causing afferent arteriolar vasoconstriction and sodium retention; this blunts ACE-inhibitor-mediated vasodilation and reduces GFR.
Клиническое значение
Blood pressure may rise 3–5 mmHg on average; in high-risk patients (HF, CKD, dehydration), acute kidney injury and hyperkalemia can occur.
Тактика ведения
Avoid chronic NSAID use in ACE inhibitor-treated patients; monitor serum creatinine and potassium within 1–2 weeks of initiating NSAID. Prefer acetaminophen for analgesia.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.