The answer, step by step

1. 1The NSAID narrows the way inProstaglandins keep the vessel into each filter openNSAIDs cut prostaglandins, so less blood gets inWhy? →
2. 2The ACE inhibitor loosens the way outAngiotensin II tightens the vessel leaving each filterBlock it, and filtration pressure can’t be held upWhy? →
3. 3The diuretic lowers the volumeLess fluid in the circulationEven less blood reaches the kidneys — worse with dehydrationWhy? →
4. 4Acute kidney injuryFiltration pressure collapsesCreatinine rises, and potassium can climbWhy? →

What to do

• Do thisDon’t add the third drugAsk about over-the-counter ibuprofen and naproxenOffer a safer pain relief option for someone on both
• Do thisDehydrating illness? Sick-day adviceVomiting, diarrhoea or fever: these medicines may need a short pauseRestart once eating and drinking normally — follow local guidance
• Do thisCheck the kidneysRenal function and electrolytes when starting or changingRecheck after any acute illness