A 70-year-old woman with CKD stage 3b and poorly controlled hypertension is started on ramipril. Two weeks later, creatinine rises from 120 µmol/L to ...

Question

A 70-year-old woman with CKD stage 3b and poorly controlled hypertension is started on ramipril. Two weeks later, creatinine rises from 120 µmol/L to 150 µmol/L and potassium from 4.5 to 5.0 mmol/L. She is asymptomatic. According to CKD and hypertension guidance, what is the most appropriate management?

Accepted Answer

Continue current ramipril dose and recheck labs in 1-2 weeks

Answer

Stop ramipril immediately and never reintroduce

Answer

Reduce the ramipril dose by half and recheck labs in 1-2 weeks

Answer

Switch to an NSAID for blood pressure control

Answer

Start potassium supplements

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