A 75-year-old man comes to the office due to abnormal findings during physical examination last week. An abdominal bruit was discoverd and in further evaluation reveals bilateral renal artery stenosis. He has a long term hypertension for which he takes amlodipine but blood pressure reading shows uncontrolled blood pressure. Therefore, a daily lisinopril is added and the patient is advised to follow up in a few days. The close follow-up is recommended due to which of the following anticipated effects in this patient's kidney function?

Question

Quizplus · Accepted Answer

Eductional Objective: ACE inhibitors block angiotensin II-mediated vasoconstriction, and this promot reduction in systemic blood pressure and lower renal perfusion.  In addition, ACE inhibitors cause dilation of the efferent arteriole, leading to a reduction in glomerular filtration rate and renal filtration fraction. In patients with bilateral renal artery stenosis are dependent on angiontensin II to induce efferent artery vasoconstriction to maintain glomerular filtration rate due to decrease renal perfusion.

A 75-Year-Old Man Comes to the Office Due to Abnormal