Q: A majority of ESRD (End Stage Renal Disease) patients are either on angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). How many days before elective surgery they should be preferably discontinued?


Answer:  48 hours

A majority of patients, with ESRD and on dialysis are either on ACE-inhibitors or ARBs. Ideally, it should be held at least 48 hours before surgery to avoid refractory vasodilation/vasoplegia.