Chapter 39 – CKD & Drugs in Renal Disease (QE) Sample Questions
1. MT is a 65-year-old man with chronic kidney disease (CKD stage 3), type 2 DM and hypertension. His current medications include ramipril 10 mg daily, insulin glargine daily and insulin Aspart twice daily and atorvastatin 40 mg daily. His blood pressure remains elevated at 150/92 mmHg despite adherence to therapy. . Based on current evidence,the most appropriate drug to add is?
- A. Hydrochlorothiazide
- B. Amlodipine
- C. Furosemide
- D. Metoprolol
Ans:
B
Tips: • The ACCOMPLISH trial compared ACE inhibitor + amlodipine (dihydropyridine CCB) vs ACE inhibitor + thiazide (hydrochlorothiazide).
• Results showed ACEI + CCB significantly reduced cardiovascular events and provided better renal protection, especially in patients with CKD or high cardiovascular risk.
• Thiazides are less effective in advanced CKD (eGFR <30 mL/min).
Save My Preference