CT is a 69-year-old white male with hypertension and a histo…
CT is a 69-year-old white male with hypertension and a history of chronic kidney disease and proteinuria. Today he has a creatinine clearance of 48 mL/minute. At his visit today he reports some new swelling in his ankles that has increased since his dose of amlodipine was increased. He reports that the edema limits his ability to put his shoes on and do work around the house. He brings a month’s worth of home blood pressure readings, and the readings are as follows: SBP DBP HR Maximum: 158 94 64 Minimum: 138 80 55 Average: 143 84 59 Medications: Amlodipine 10mg daily Labs: Potassium: 4.0 mEq/L Creatinine clearance – 48 mL/minute Urinary Protein:creatinine ratio – 1477 mg/g (< 300 mg/g) Which of the following would be the BEST plan to reduce his blood pressure AND hopefully reduce some of his amlodipine-induced edema?