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Spironolactone renal impairment — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone renal impairmentGPhC CRA

A heart failure patient with eGFR 32 mL/min/1.73 m2 starts spironolactone 25 mg daily. The GP asks what monitoring is important after initiation. What monitoring is required?

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Correct answer: E — Check renal function and serum potassium soon after starting and after dose changes

Spironolactone can cause hyperkalaemia and worsening renal function, especially in patients with renal impairment and heart failure. Renal function and potassium should be checked soon after initiation and after dose adjustments. Ongoing monitoring is required according to risk. INR and peak flow are not the relevant routine monitoring tests.

Reference: BNF; NICE CKS