ARBs can cause which serious renal-related adverse effect?

• A. Life-threatening renal dysfunction
• B. Hyperglycemia
• C. Hypotension alone
• D. Hepatotoxicity

Answer: (A)

ARBs can precipitate acute kidney injury in patients with compromised renal perfusion, especially with bilateral renal artery stenosis or a solitary functioning kidney. Blocking Ang II prevents constriction of the efferent arteriole, which normally helps maintain glomerular filtration pressure. When this constriction is blocked in a kidney with reduced blood flow, the glomerular pressure drops, GFR falls, and creatinine rises. This can be life-threatening if AKI develops. Other options like hyperglycemia or hepatotoxicity aren’t typical renal-specific adverse effects, and while hypotension can occur, the more concerning renal outcome in this context is acute kidney injury due to impaired intraglomerular pressure.