Question of the Week

For June 27, 2017

A 55-year-old woman with stage 3 chronic kidney disease secondary to polycystic kidney disease has a blood pressure of 118/62 mm Hg. Apart from enlarged kidneys to palpation, her physical examination is unremarkable, and she has no symptoms. Her only medication is lisinopril 10 mg once daily. Several members of her family have a history of coronary artery disease.

Laboratory testing yields the following results:

Patient value

Reference range

Serum creatinine (mg/dL)

2.5

0.6–1.1

Estimated glomerular filtration rate

(mL/min/1.73 m2)

33

≥60

Urinary protein (mg/24 hr)

110

<150

LDL cholesterol (mg/dL)

135

<130

HDL cholesterol (mg/dL)

55

≥46

Total cholesterol (mg/dL)

220

125–200

The addition of which one of the following types of medication is most likely to reduce this patient’s risk for a major cardiovascular event?

Aspirin
Angiotensin-receptor blocker
Loop diuretic
Statin
Beta-blocker