In CKD with GFR < 60 the rule is to avoid nephrotoxins, and NSAIDs such as ibuprofen are the classic example: they constrict the afferent arteriole, reduce renal blood flow and can cause AKI on CKD.

• Lisinopril is not to be avoided — ACE inhibitors are indicated in diabetic nephropathy to reduce proteinuria and slow progression.
• Iron and low-dose aspirin are not the nephrotoxic drugs the sources warn about.