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ACE inhibitor renal function change — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentACE inhibitor renal function changeGPhC CRA

A patient started lisinopril two weeks ago. Repeat blood tests show creatinine has risen from 82 to 116 micromol/L and potassium is 5.7 mmol/L. The GP asks for pharmacy advice before issuing the repeat. What monitoring is required?

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Correct answer: E — Recommend urgent prescriber review because potassium is high

ACE inhibitors can cause rises in creatinine and potassium, but significant hyperkalaemia needs prompt review. Potassium of 5.7 mmol/L is clinically important, especially after ACE inhibitor initiation. Potassium supplements or salt substitutes would worsen risk. The renal function change should be interpreted alongside BP, volume status and local guidance.

Reference: BNF; NICE CKS