A 69-year-old male presents to your department for follow-up. The patient has a long history of type 2 diabetes mellitus and has been diagnosed with chronic kidney disease (CKD). He takes insulin and is scheduled to start dialysis in 2 weeks. Vital signs are blood pressure 175/105 mmHg, pulse 80 bpm, respiration 17 bpm, and temperature 36.8°C. Labs done a week ago revealed that the patient's HbA1c is 6.8% and eGFR: 14 ml/min/1.73 m². Which of the following is the most appropriate initial antihypertensive treatment for this patient?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Fosinopril
In diabetic CKD with hypertension, first-line antihypertensives are RAAS inhibitors (ACE inhibitor or ARB). They lower BP and proteinuria, slow CKD progression and reduce cardiovascular events. Fosinopril is the ACE inhibitor offered; check creatinine and K⁺ after starting.
- Thiazides lose effect at very low GFR.
- Loop diuretics are used mainly for volume overload or hyperkalaemia.
- Amlodipine is an add-on, not first choice in diabetic nephropathy.
- المصدر
- CKD +RRT.pdf · p. 3
Chronic Kidney Disease (CKD).pdf · p. 10 - المحاضرة
- AKI & CKD · Nephrology · Module C
- ظهر في
- MED43 ♀ Quiz C · MED41 ♀ EOM C