Nephrotoxicity in the elderly due to co-prescription of angiotensin converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs

Both angiotensin converting enzyme. inhibitors and nonsteroidal anti-inflam matory drugs can lead to functional renal insufficiency. In an observationa l study we assessed the frequency of this adverse effect in patients aged o ver 75 years receiving these drugs in combination. In one year, out of 1500 patients whose records were screened, 12 were prescribed this combination. 2 developed acute renal failure, of whom one died and the other recovered after discontinuation of both drugs. 4 patients showed deterioration in ren al function, which returned to normal after one of the drugs was stopped. R enal function remained stable in 6 patients: patients with deterioration in renal function were older and more likely to be on diuretics. This drug combination is commonly nephrotoxic in the elderly and should be avoided, especially in those taking diuretics.