Which class of medication is often avoided in patients with renal impairment?

The avoidance of certain medications in patients with renal impairment is critical due to the potential for adverse effects and complications. ACE inhibitors are often associated with a risk of causing hyperkalemia and worsening renal function, particularly in individuals who have already compromised kidney function. This is because they can interfere with the renin-angiotensin-aldosterone system, leading to a reduction in glomerular filtration rate (GFR) in susceptible patients.

In cases of renal impairment, the accumulation of potassium is a particular concern. ACE inhibitors can increase potassium levels, and with renal function reduced, the kidneys may struggle to excrete excess potassium, leading to potentially dangerous hyperkalemia.

While thiazide diuretics and loop diuretics might also be used cautiously in patients with renal issues, they are sometimes employed to manage fluid overload or hypertension even within the context of reduced renal function. Diuretics can be adjusted according to the level of renal impairment. However, due to the risk of complicating renal function and electrolyte balance, ACE inhibitors are often avoided in this patient population.