Cardiovascular & Renal Drugs · NEET PG Preparation Pharmacology
A 65-year-old man with severe hypertension and bilateral renal artery stenosis is prescribed an ACE inhibitor. Within a few days, his serum creatinin…
Practice question from Cardiovascular & Renal Drugs (NEET PG Preparation Pharmacology), with the correct answer and a step-by-step solution.
hard · MCQ · Q-063BAA
A 65-year-old man with severe hypertension and bilateral renal artery stenosis is prescribed an ACE inhibitor. Within a few days, his serum creatinine significantly increases. What is the primary pathophysiological mechanism responsible for this finding?
- A.Constriction of the afferent glomerular arteriole
- B.Dilatation of the efferent glomerular arterioleCorrect answer
- C.Direct tubular necrosis induced by bradykinin accumulation
- D.Thrombosis of the renal microvasculature
Solution
In bilateral renal artery stenosis, glomerular filtration rate (GFR) depends on angiotensin II-mediated constriction of the efferent arteriole to maintain intraglomerular pressure. ACE inhibitors block angiotensin II formation, leading to efferent arteriolar vasodilation, a drop in glomerular filtration pressure, and acute renal failure.
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