A 74-year-old man with eGFR 52 mL/min/1.73 m² and UACR 90 mg/g on lisinopril asks if he should continue ACE inhibitor now that creatinine rose from 1....

Question

A 74-year-old man with eGFR 52 mL/min/1.73 m² and UACR 90 mg/g on lisinopril asks if he should continue ACE inhibitor now that creatinine rose from 1.1 to 1.3 mg/dL after initiation. Potassium is 4.8 mEq/L. What do guidelines advise?

Accepted Answer

Continue ACE inhibitor with monitoring

Answer

Stop ACE inhibitor once eGFR

Answer

Switch immediately to ARB plus potassium supplement

Answer

Stop ACE inhibitor if creatinine rises by any amount

Answer

Add spironolactone and stop ACE inhibitor

us-abim MCQ (SBA): Chronic Kidney Disease

A 74-year-old man with eGFR 52 mL/min/1.73 m² and UACR 90 mg/g on lisinopril asks if he should continue ACE inhibitor now that creatinine rose from 1.1 to 1.3 mg/dL after initiation. Potassium is 4.8 mEq/L. What do guidelines advise?