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Case 3
Clinician: Jan N. Basile, MD
A 74-year-old woman with long-standing hypertension and diabetes
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Background
- 74-year-old white woman with diabetes for 18 y
- Hypertension for 12 y, seen at nephrology clinic
- Myocardial infarction (MI) 6 y earlier followed by CABG
- ECG: LVH and previous MI
- Renal ultrasound: normal size and morphology, no stenosis of renal arteries
- K+ = 5.3, Na+ = 142, creatinine = 2.2 (24-hr creatinine clearance 28 cc/min, 1.183 g protein)
- BP 170/100 on enalapril 10, furosemide 40, labetalol 600 bid, transdermal nitroglycerin, insulin 34 units/d
- Nonsmoker
- No alcohol use
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