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Spironolactone CKD monitoring — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone CKD monitoringGPhC CRA

A patient with CKD starts spironolactone for resistant hypertension while taking lisinopril. The prescriber asks what to monitor. What monitoring is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Serum potassium and renal function soon after initiation

ACE inhibitors plus spironolactone increase hyperkalaemia risk, particularly in CKD. Potassium and renal function monitoring are essential. In this scenario, the correct option is serum potassium and renal function soon after initiation. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; NICE CKS