Question

A 70-year-old woman with stage 4 CKD (eGFR 25 mL/min/1.73 m²) and hypertension is taking ramipril 10 mg daily. Her serum potassium is persistently 6.0 mmol/L despite dietary restriction and use of a thiazide diuretic. According to CKD management principles, what is the most appropriate next step?

Accepted Answer

Cease ramipril or reduce dose and manage hyperkalaemia

Answer

Continue ramipril at the same dose and monitor potassium only

Answer

Increase ramipril dose to improve nephroprotection

Answer

Ignore hyperkalaemia because ACE inhibitors are nephroprotective

Answer

Start potassium supplementation to avoid arrhythmias

Practice question

A 70-year-old woman with stage 4 CKD (eGFR 25 mL/min/1.73 m²) and hypertension is taking ramipril 10 mg daily. Her serum potassium is persistently 6.0 mmol/L despite dietary restriction and use of a thiazide diuretic. According to CKD management principles, what is the most appropriate next step?