مريض بدأ ليسينوبريل، وبعد أسبوعين ارتفع الكرياتينين بأكثر من ٥٠٪ عن قيمته السابقة. أي حالة يجب أن يفكر فيها الطبيب؟

Two weeks after starting lisinopril, a client’s creatinine has risen more than 50% from baseline. Which condition should be considered?

1. Bilateral renal artery stenosis
2. A normal improvement in kidney function
3. An allergic skin reaction
4. Mild dehydration needing no assessment

Answer: A) Bilateral renal artery stenosis. A small creatinine rise is expected with ACE inhibitors, but a large rise suggests bilateral renal artery stenosis, where filtration depends on angiotensin. The prescriber is told so the drug can be stopped and assessed.