Question

A 58-year-old man with CKD stage 3 is started on Ramipril for hypertension and proteinuria. Baseline creatinine is 140 micromol/L. Two weeks later, creatinine is 160 micromol/L (about a 14% rise) and potassium is 4.9 mmol/L. He is otherwise well. What is the most appropriate management?

Accepted Answer

Continue Ramipril and recheck renal function in a few weeks

Answer

Stop Ramipril immediately as any rise in creatinine is unacceptable

Answer

Double the Ramipril dose immediately

Answer

Stop Ramipril and start an NSAID for blood pressure control

Answer

Start high-dose loop diuretic to lower creatinine

Practice question

A 58-year-old man with CKD stage 3 is started on Ramipril for hypertension and proteinuria. Baseline creatinine is 140 micromol/L. Two weeks later, creatinine is 160 micromol/L (about a 14% rise) and potassium is 4.9 mmol/L. He is otherwise well. What is the most appropriate management?