A 66-year-old with stage 3 CKD (eGFR 47) and albuminuria has serum creatinine increased after starting ACE inhibitor. Potassium 4.9. BP 128/78. What i...

Question

A 66-year-old with stage 3 CKD (eGFR 47) and albuminuria has serum creatinine increased after starting ACE inhibitor. Potassium 4.9. BP 128/78. What is appropriate?

Accepted Answer

Continue ACE inhibitor if creatinine increase is ≤30% from baseline and potassium acceptable

Answer

Stop ACE inhibitor immediately if creatinine rises any amount

Answer

Switch to ARB

Answer

Add spironolactone regardless of potassium

Answer

Increase protein intake

us-abim MCQ (SBA): CKD-RAAS Blockade

A 66-year-old with stage 3 CKD (eGFR 47) and albuminuria has serum creatinine increased after starting ACE inhibitor. Potassium 4.9. BP 128/78. What is appropriate?