How to deal with the effect of renal impairment on management of other patient conditions

摘要

The management of stable chronic kidney disease, hypertension, and obesity in a 61-year-old Caucasian man is being reviewed. The patient has never smoked. Nor does he have diabetes or significant proteinuria. His various measurements and test results are as follows:BP 145/95mmHg (six months ago it was 165/102mmHg) Serum potassium 4.4mmol/L (normal range 3.5-5mmol/L) Serum creatinine 260μmol/L (normal range 60-110μmol/L) eGFR 23ml/minute/1.73m2 (ie, se-vere [stage 4] renal impairment) Pasting total cholesterol 3.4mmol/L Liver function normal Urea and other electrolytes normal.