Does concurrent use of diuretics, ACE inhibitors or ARBs, and NSAIDs increase the risk of acute kidney injury?
Vigilance is warranted when antihypertensive drugs (diuretics, ACEi/ARBs) are used concurrently with NSAIDs due to an increased risk of acute kidney injury, particularly at the start of treatment.
A triple therapy combination consisting of diuretics with angiotensin converting enzyme inhibitors or angiotensin receptor blockers and NSAIDs was associated with an increased risk of acute kidney injury. The risk was greatest at the start of treatment. Although antihypertensive drugs have cardiovascular benefits, vigilance may be warranted when they are used concurrently with NSAIDs.
Lapi et al. (2013) studied this question.