What Is The Chance Of Kidney Failure On Lisinopril?

In our latest question and answer, the pharmacist discusses the chances of kidney failure are while taking lisinopril.

Question

How big is the risk of kidney damage or failure with lisinopril?

Asked by Elizabeth On May 18, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On May 22, 2018

Treatment with all ACE-Inhibitors, such as Zestril (lisinopril), are associated with a small risk of kidney dysfunction or rarely, acute renal failure. However, most, if not all adverse changes to kidney function are reversible upon discontinuation of the drug.


Most commonly, minor increases in blood urea nitrogen (BUN) and serum creatinine are seen but are again, reversible upon discontinuation of therapy. These kidney function changes are seen in about 2% of patients treated with lisinopril alone for high blood pressure according to the prescribing information. BUN and creatinine increases are more common (~11.6%) in patients those also taking diuretics. 


In one clinical trial, the GISSI-3 trial, lisinopril-treated patients had an incidence of renal dysfunction of 2.4%, which led to stopping the medication in 2% of patients. In the elderly, discontinuation due to renal dysfunction was increased to 4.2%.


In another clinical trial, the ATLAS trial, similar results were seen, with elevated creatinine and blood urea nitrogren levels being seen in lisinopril treated patients. However, as discussed above, these increases were reversible upon discontinuation of therapy.


It is important to note that the risk of kidney dysfunction while taking lisinopril is higher in susceptible individuals, which include those with:

  • Congestive heart failure
  • Renal artery stenosis
  • Chronic kidney disease
  • Post-myocardial infarction (heart attack)


Lastly, the potential side effects that affect the kidney and urogenital system include:

  • Acute renal failure
  • Oliguria (low production of urine)
  • Anuria (failure to product urine)
  • Uremia (increased levels of urea)
  • Azotemia (increased nitrogen waste in urine)
  • Renal dysfunction
  • Dysuria (painful urination)


Dosing of lisinopril is dependent on kidney function. If you have decreased kidney function, as measured by creatinine clearance, your dose of lisinopril will be adjusted.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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