A 62-year-old woman with stage 3b CKD on lisinopril presents with volume depletion following aggressive diuresis. Vitals show BP 98/62, HR 102, RR 18, temp 37°C. Serum creatinine is 2.1 mg/dL with eGFR 28 mL/min/1.73m². The macula densa senses reduced tubular sodium chloride delivery. No orthostatic hypotension is documented. Which compensatory renal mechanism is most likely activated in response?
- A)Increased atrial natriuretic peptide release
- B)Suppressed sympathetic tone to the afferent arteriole
- C)Increased renin release from juxtaglomerular cellsGABARITO
- D)Reduced angiotensin II production
- E)Decreased prostaglandin synthesis with afferent constriction
Explicação
Low sodium chloride delivery to the macula densa signals decreased effective circulating volume. This promotes renin release from juxtaglomerular cells, activating the RAAS to restore blood pressure and filtration. Ver explicação completa e trilha adaptativa →