In CrCl < 30 mL/min, which drug should be avoided because it can cause hyperkalemia and hyponatremia?

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Multiple Choice

In CrCl < 30 mL/min, which drug should be avoided because it can cause hyperkalemia and hyponatremia?

Explanation:
The key idea is that potassium-sparing diuretics should be avoided when kidney function is severely reduced (CrCl < 30 mL/min) because they can cause dangerous hyperkalemia. Triamterene works by directly blocking the epithelial sodium channel in the collecting duct, which lowers sodium reabsorption and reduces potassium loss. In the setting of poor renal function, this can lead to potassium buildup in the blood. It can also contribute to hyponatremia because of increased sodium loss in the urine. Because of these electrolyte risks in advanced CKD, this drug is specifically avoided in CrCl < 30 mL/min.

The key idea is that potassium-sparing diuretics should be avoided when kidney function is severely reduced (CrCl < 30 mL/min) because they can cause dangerous hyperkalemia. Triamterene works by directly blocking the epithelial sodium channel in the collecting duct, which lowers sodium reabsorption and reduces potassium loss. In the setting of poor renal function, this can lead to potassium buildup in the blood. It can also contribute to hyponatremia because of increased sodium loss in the urine. Because of these electrolyte risks in advanced CKD, this drug is specifically avoided in CrCl < 30 mL/min.

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