@entity294 , @entity391 and XXXX inhibitors:--an important cause of @entity810 .

@entity1 @entity8 @entity1289 @entity294 @entity391 @entity810 @entity17823 @entity1011
The occurrence of severe @entity810 in 3 @entity1 who developed @entity294 while taking @entity1289 ( @entity1289 ) inhibitors led us to undertake a retrospective cohort survey to determine the frequency with which @entity294 and @entity391 are associated with @entity810 in @entity1 taking this class of drug. Serum @entity1011 was measured as part of the diagnostic workup of 2398 consecutive admissions to an acute medical receiving unit in a district general hospital. Outcome measures were the presence of @entity294 , and whether taking an @entity1289 inhibitor, NSAID or diuretic at the time of admission, also previous, initial and follow up serum @entity1011 concentrations. Peak serum @entity1011 in the 3 cases was 1159, 989 and 765 micromol/l. None of the 3 required dialysis and all recovered renal function completely after receiving large volumes of intravenous fluid. In the cohort study, 89 of 2398(3.7%) admissions had serum @entity1011 >/=200 micromol/l. Nine were regular dialysis @entity1 . Of the remaining @entity1 , 30 (37.5%) were taking an @entity1289 inhibitor. Six of 30 (20%) gave a history of @entity294 . Median @entity1011 concentration in this group was 135 (range 111-209) micromol/l before admission, 292 (216-724) micromol/l when first seen in hospital, and 134 (94-219) micromol/l following the withdrawal of drug therapy and fluid replacement. In conclusion, @entity17823 causing @entity810 in @entity1 taking @entity1289 inhibitors is not uncommon. Such @entity1 and their general practitioners should be aware that reversible @entity8 may occur during intercurrent illnesses, particularly if characterised by @entity294 .
