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ACE Inhibitors and NSAIDs in the Emergency Department?
The problem arises because we use ACE inhibitors for patients with stable chronic kidney disease to reduce progression over many years. If you then add on any other nephrologic insult, we advise patients to stop taking their ACE and ARBs. In the emergency room setting, I think you're well within your rights to tell the sick patient who's well enough to go home but whose oral intake is not quite back to normal.