A 45-year-old man with a history of stage 2 chronic kidney disease and hypertension presents to the clinic for evaluation of leg edema. His recent laboratory findings indicate proteinuria and stable stage 2 chronic kidney disease. His blood pressure today is 150/85 mm Hg. He is taking lisinopril 40 mg daily for hypertension. Which of the following is the best next step in the management of his hypertension?

a. Angiotensin II receptor blockers
b. Dihydropyridine calcium channel blockers
c. Loop diuretic
d. Nondihydropyridine calcium channel blockers



Answer :

Given the patient's history of stage 2 chronic kidney disease and proteinuria, the best next step in the management of his hypertension would be to continue with an ACE inhibitor like lisinopril (option a). ACE inhibitors are recommended as first-line agents for patients with chronic kidney disease and proteinuria due to their renal protective effects. It is important to monitor renal function and potassium levels regularly while on ACE inhibitors.

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