Temporarily stopping taking medicine to prevent acute kidney injury when unwell: risks and benefits

Kidney function can decrease suddenly when someone becomes unwell, for example with an infection or diarrhoea and vomiting. This is more likely when the person is elderly, has other medical problems or is taking certain medicine.

This drop in kidney function is called acute kidney injury (AKI) and can mean a higher chance of being admitted to hospital and spending longer there. One in four patients admitted to hospital with acute kidney injury do not survive. Those that do are often left with long term kidney damage.

Experts suggest that stopping taking certain medicines during illnesses may reduce the chance of acute kidney injury.

Project aims

This project looked at whether stopping certain types of medicine for a short time when someone becomes unwell can reduce the risk of developing acute kidney injury.

What we did

This ‘systematic review’ involved finding all the studies that met our criteria, critically evaluating them, and summarising their results.

We included studies that looked at the effect of stopping taking certain medicines on the risk of acute kidney injury in adults who were:

  • unwell
  • going to have an operation
  • going to have an imaging procedure

We included studies of the last two groups because we didn’t expect to find many studies of people who were unwell.

What we found and what this means

We found six studies to include in our review. Five studies looked at people having coronary angiography (a test that shows the insides of the arteries that supply blood to your heart) and one looked at people having heart surgery. We didn’t find any studies on stopping taking medicines when people were not in hospital and became unwell.

The studies that we looked at found that people who continued to take their medicines prior to the angiography or surgery had a small increased risk of kidney injury, compared to those that stopped taking them.

What next?

This review has shown that there is a need for more research to look at the effect of stopping taking medicines on kidney function in people who aren’t in hospital, when they are unwell.

Lead collaborators

CLAHRC West staff

Tracey Stone

Dr Tracey Stone

Jeremy Horwood

Dr Jeremy Horwood

  • Senior Research Fellow in Ethnography / Qualitative Social Science
  • Ethnography
  • Team Lead

Partners on this project

Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group

NHS Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG CCG) is the organisation responsible for commissioning hospital and community health services to ensure that the health needs of BNSSG's population are met. It is made up of local GPs and health professionals from the 85 local practices, working together with other clinicians and patients to decide how the local NHS budget should be spent.

North Bristol NHS Trust

North Bristol NHS Trust is one of the largest teaching trusts in the country and serves the population of Bristol, South Gloucestershire and North Somerset. Their internationally renowned specialist areas include neurosciences, renal, orthopaedics, major trauma, urology, plastic surgery and neo-natal intensive care.

University Hospitals Bristol NHS Foundation Trust

University Hospitals Bristol NHS Foundation Trust is a dynamic group of hospitals in the heart of Bristol, with over 100 clinical services across nine sites. They offer care to the people of Bristol and the South West, and have an international reputation for cardiac surgery, paediatric services, oncology and bone marrow transplantation and are the largest centre for medical training and research in the South West.