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A 78-year-old man with diabetes and hypertension was referred because of acute renal failure (serum creatinine, 3.2 mg per deciliter) and hyperkalemia (potassium, 6.3 mmol per liter) due to obstructive uropathy. His medications included 40 mg of furosemide (Lasix) twice daily, 20 mg of lisinopril (Prinivil) twice daily, and 250 mg of chlorpropamide (Diabinese) per day. A Foley catheter was placed, the lisinopril was discontinued, and three doses of sodium
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