MRCP2-4101
A 62-year-old woman presents to the low clearance renal clinic with a history of chronic kidney disease stage IV due to bilateral ureteric injury during a previous hysterectomy. She reports feeling well except for mild ankle swelling. Her current medications include losartan, alfacalcidol, calcium, cholecalciferol, and sodium bicarbonate. On examination, her blood pressure is 175/91 mmHg, heart rate is 92 beats per minute, and JVP is visible at 4cm with pitting edema to the ankles. Her blood tests reveal a creatinine level of 387 µmol/l and a potassium level of 5 mmol/l. Which medication should be added to manage her hypertension?