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Aarav Sharma

Flagged for reviewDemo data (offline)

MRN-48213

Stage: CLINICIAN_REVIEW

Findings

  • CriticalRequires reviewPossible concern

    Recent potassium of 6.2 mmol/L identified in a patient on lisinopril 20 mg daily suggests possible ACE-inhibitor-associated hyperkalemia and may warrant review before this visit.

    Serum potassium has risen from 4.4 to 6.2 mmol/L over three draws following initiation of lisinopril in a patient with pre-existing stage 3 chronic kidney disease. The FDA label for ACE inhibitors identifies hyperkalemia as a labeled risk, particularly with renal impairment. No subsequent evidence identified that this trend has been addressed in the chart.

    Consider repeat basic metabolic panel prior to prescribing, and clinician review of lisinopril dosing in the context of renal function and potassium trend.

    • Potassium (BMP): 6.2 mmol/L on 2026-08-14 (reference range 3.5–5.0 mmol/L)
    • Potassium (BMP): 5.1 mmol/L on 2026-07-30 (reference range 3.5–5.0 mmol/L)
    • Active medication: Lisinopril 20 mg PO daily, started 2026-07-02
    • Active diagnosis: Chronic kidney disease, stage 3 (eGFR 52 mL/min/1.73m²)

Patient history

Showing 15 of 15 timeline events.
  1. 2024-01-15
    Annual wellness visit
    Routine physical; blood pressure mildly elevated at 138/86 mmHg. Renal function first noted as borderline.
  2. 2024-01-15
    eGFR 68 mL/min/1.73m²
    Basic metabolic panel; mildly reduced but not yet diagnostic of chronic kidney disease.
  3. 2024-06-20
    Hypertension diagnosed
    Stage 1 hypertension; lifestyle modification recommended before pharmacologic therapy.
  4. 2024-11-05
    Potassium 4.2 mmol/L
    Basic metabolic panel, within reference range (3.5–5.0 mmol/L).
  5. 2024-11-05
    eGFR 61 mL/min/1.73m²
    Basic metabolic panel; continued gradual decline in renal function.
  6. 2025-03-12
    Follow-up visit
    Blood pressure remains elevated at 142/88 mmHg despite lifestyle changes; pharmacologic therapy discussed.
  7. 2025-09-18
    eGFR 58 mL/min/1.73m²
    Basic metabolic panel; further decline consistent with early chronic kidney disease.
  8. 2025-09-18
    Potassium 4.4 mmol/L
    Basic metabolic panel, within reference range (3.5–5.0 mmol/L).
  9. 2026-05-18
    Chronic kidney disease, stage 3 diagnosed
    eGFR 54 mL/min/1.73m², confirmed on repeat testing.
  10. 2026-07-02
    Lisinopril 20 mg daily started
    Initiated for blood pressure management.
  11. 2026-07-30
    Potassium 5.1 mmol/L
    Basic metabolic panel, mildly elevated above reference range.
  12. 2026-07-30
    eGFR 51 mL/min/1.73m²
    Basic metabolic panel; modest further decline after ACE-inhibitor initiation.
  13. 2026-08-14
    Potassium 6.2 mmol/L
    Basic metabolic panel, markedly elevated above reference range.
  14. 2026-08-14
    eGFR 47 mL/min/1.73m²
    Basic metabolic panel; renal function has declined further, compounding hyperkalemia risk.
  15. 2026-08-18
    Chart prepared for upcoming visit
    Pre-visit chart review generated ahead of scheduled follow-up.

Recent labs

  • PotassiumCritical
    6.2 mmol/Las of 2026-08-14
  • eGFRLow
    47 mL/min/1.73m²as of 2026-08-14
  • CreatinineHigh
    1.6 mg/dLas of 2026-08-14