Which ACE inhibitors are considered safer for patients with renal impairment?

The correct answer highlights Captopril and Moexipril as ACE inhibitors that are considered safer for patients with renal impairment. Captopril is primarily eliminated by the kidneys, and while it can be used with caution in patients with renal issues, it still requires monitoring of renal function.

Moexipril is favored for patients with renal impairment because it has a reduced dependency on the kidneys for elimination compared to some other ACE inhibitors. This characteristic diminishes the risk of accumulating potentially harmful levels of the medication in patients with compromised renal function.

In contrast, other options like Fosinopril and Enalaprilat can pose higher risks in those with renal issues due to their pharmacokinetics. For instance, Fosinopril, while also renal-friendly, has a strong renal clearance component and could increase risks if not monitored. Enalaprilat is more potent and can lead to rapid blood pressure changes, which might complicate management in renal impairment situations. Therefore, the safest pair for this population are Captopril and Moexipril, owing to their more favorable profiles regarding renal elimination.