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Angiotensin-Converting Enzyme Inhibitors (ACE-I) or Angiotensin Receptor Blockers (ARBS) are commonly used for patients with hypertension. This drug is the first choice for hypertension treatment due to its works in lowering blood pressure and renoprotection. Another effects of this drugs is increase creatinine serum. A 68 years old woman with hypertension was hospitalized in July 2012. This woman was diagnosed to stage 5 chronic kidney disease (CKD) with serum creatinine level was 4.29 mg/ dL, after 5 days increased to 5.5 mg/dL. This patient used is valsartan for 8 months, which replaced with lisinopril until 26 July 2012. Serum creatinine levels was fluctuated while using the treatment and increased during the last one year. In May 2012, when the patient do regularly control, serum creatinine level is 3.16 mg/dL. Adverse drug reactions of lisinopril and valsartan can increase the serum creatinine level by 20–30% from base line score. Therefore, in early August 2012, the drug was discontinued and evaluated on 4th of August, the serum creatinine level of the patient decreased to 4.96 mg/dL from 5.55 mg/dL. The result of Naranjo scale indicated that the use of valsartan/lisinopril cause adverse drug reactions. Monitoring is required for the patient who use ACEI or ARB therapy, so adverse drug reactions can be found from the beginning and the management of drug can be considered appropriately.

Increase of Serum Creatinine as the Outcome of ACEi or ARB Use