AKT-3715

AKT-3715

A 65-year-old man visits his GP for his annual health check-up. During the check-up, the GP diagnosed him with hypertension and prescribed ramipril 2.5mg OD. The patient is also taking lansoprazole 30 mg OD, furosemide 20 mg OD, and atorvastatin 40 mg ON.

The patient’s U+E levels have been stable, but a recent blood test showed:
– Na+ 139 mmol/L (135 – 145)
– K+ 4.8 mmol/L (3.5 – 5.0)
– Urea 7.5 mmol/L (2.0 – 7.0)
– Creatinine 140 µmol/L (55 – 120)
– eGFR 47 ml/min/1.73m2

One month later, the GP requested a repeat U+E test, which showed:
– Na+ 139 mmol/L (135 – 145)
– K+ 6.1 mmol/L (3.5 – 5.0)
– Urea 8.5 mmol/L (2.0 – 7.0)
– Creatinine 150 µmol/L (55 – 120)
– eGFR 43 ml/min/1.73m2

The patient’s ECG was normal. What is the most appropriate management plan, in addition to re-checking the U+E levels?