Importance d'interrompre certains médicaments en cas de troubles digestifs et de déshydratation

This clinical case draws attention to the importance of stopping some medications in case of gastrointestinal disturbances that could induce dehydration. The latter can provoke an acute renal failure, which may lead to a toxic accumulation of these pharmacological agents and/or increase their nephrotoxicity. This may induce a vicious circle that is potentially dangerous and even fatal. Three pharmacological classes that are widely used in clinical practice are considered as examples, metformin, inhibitors of the renin-angiotensin system and nonsteroidal anti-inflammatory drugs. For each of them, the pathophysiology of the complication will be briefly discussed. Some patient risk profiles where caution is mandatory will be also emphasized.