Angiotensinconverting enzyme inhibitors (ACEI) 及angiotensinII receptor blockers (ARB) 目前廣泛用於治療高血壓、慢性腎病及心衰竭。使用這類型藥物卻有可能導致某些副作用發生。其中急性腎衰竭、高血鉀等與直接或間接作用在angiotensin II type 1 receptor (AT1) 接受器上有關。ACEI 及ARB 造成急性腎損傷的機轉，主要是這類型藥物會作用在AT1，造成腎絲球出球小動脈擴張，反而造成腎絲球內壓力梯度消失、腎絲球過濾率無法維持而損傷腎功能。本文敘述一位高血壓的病人，有type 2 diabetes mellitus (DM) 及colon cancer 疾病史，口服amlodipine 5 mg & olmesartan 20 mg (Sevikar®) 約一年，由於噁心嘔吐合併嚴重脫水，出現急性腎臟損傷 (acute kidney injury, AKI) 的症狀，在停用藥物及腎臟超音波檢查後由門診追蹤照護。藉由文獻回顧，探討此案例使用之amlodipine 5 mg & olmesartan 20 mg (Sevikar®) 引發急性腎臟損傷之成因及可能性，提供醫師及藥師未來在使用藥物及衛教之處理方式。

Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are widely used in the treatment of hypertension, chronic kidney disease (CKD), and heart failure. However, the use of these types of drugs may lead to severe adverse effects. The adverse effects such as acute renal injury and hyperkalemia are the major problems related to angiotensin II type 1 receptor (AT1). ACEI and ARB targeting on AT1 result in dilation of efferent arteriole, and subsequently cause glomerular pressure gradient lost, a decrease in renal filtration rate, and induced acute kidney injury (AKI). In this report, a patient with hypertension, type 2 diabetes mellitus (DM), and colon cancer took amlodipine 5 mg & olmesartan 20 mg (Sevikar®) orally. Severe nausea, vomiting, dehydration, and AKI occurred afterthe patient took Sevikar® for a year. This case study reports and discusses issues regarding ARB induced AKI for health-care providers to prevent adverse drug effects.