Which laboratory values should be monitored in a hypertensive Native American man with mild renal insufficiency on lisinopril?

In managing a hypertensive patient, particularly one on an ACE inhibitor like lisinopril, it is essential to monitor specific laboratory values that reflect both the medication's efficacy and the patient's renal function.

Serum creatinine is a critical marker for kidney function, especially in a patient with mild renal insufficiency, as it can indicate any worsening of renal function or possible acute kidney injury, which is a potential side effect of lisinopril. Additionally, monitoring potassium levels is vital because lisinopril can cause hyperkalemia, particularly in patients with renal impairment. The kidneys play a key role in potassium excretion, and any dysfunction can lead to elevated potassium levels, which can be life-threatening if not detected and managed promptly.

In contrast, monitoring hemoglobin, hematocrit, and MCV (the first option) is more relevant to assessing anemia and blood disorders rather than the direct effects of lisinopril or renal function. The second choice includes liver enzymes like aspartate aminotransferase and alanine aminotransferase, which are primarily indicators of liver health and not directly relevant to the management of hypertension or the effects of lisinopril. Lastly, while serum sodium, potassium, and magnesium could provide useful