Older people drug-disease interactions

People at greatest risk for nephrotoxicity have chrmiic kidney disease (CKD), hepatic disease with ascites, decompensated cOTigestive heart failure, intravascular volume depletion, or systemic lupus erythematosus (Perazella 2005). Additional risk factors include atherosclerotic cardiovascular disease and concurrent diuretic therapy. The elderly are also at higher risk due to interaction of prevalent medical problems, multiple drug therapies, and reduced renal hemodynamics. NS AID use in patients older than 65 years may increase the risk of AKI by up to 58% (Griffin et al. 2000). Combined NSAID or COX-2 inhibitor and ACEI or ARB therapy is also a concern and should be avoided in high risk patients. 

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