Mrs. G, 62 years/F, having diabetes and hypertension since nearly 25 years develops early nephropathy with a s. creatinine of 1.54 mg/dl. The eGFR is 42 ml/min (stage 3 CKD). She is given atenolol 50 mg/day in addition to amlodipine and losartan for her hypertension. After about 6 months, she develops a diabetic foot infection. Her s.creatinine has increased to 1.71 mg/dl (eGFR 38 ml/min). She is admitted. The BP remains uncontrolled.
Dose of atenolol is increased to 100 mg/day along with other antihypertensives. After admission there is a gradual increase of s.creatinine at about 0.1 mg/dl per day. This is attributed to the diabetic foot infection. The atenolol dose is continued at 100 mg/day. After admission the s. creatinine is 2.19 mg/dl (eGFR 29 ml/min). It increases to 2.48 mg/dl (eGFR 28 ml/min), then 2.84 mm/dl. However the dose of atenolol was not reduced inadvertently. The…
