This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S, Subject name: Medicine
Enalapril use is not advisable in the following conditions except 
Select and explain. 
A. Single kidney, B. Diabetic nephropathy with albuminuria, C. Bilateral renal aery stenosis, D. Hyperkalemia
B: Diabetic nephropathy with albuminuria
Answer: B: Diabetic nephropathy with albuminuria 
Explanation: ACE inhibitors (e.g. enalapril 20 mg daily, ramipril 5-10 mg daily or lisinopril 10-40 mg daily). These inhibit the conversion of angiotensin I to angiotensin II and are usually well tolerated. They should be used with paicular care in patients with impaired renal function or renal aery stenosis because they can reduce the filtration pressure in the glomeruli and precipitate renal failure. Electrolytes and creatinine should be checked before and 1-2 weeks after commencing therapy. Side-effects include first dose hypotension, cough, rash, hyperkalaemia and renal dysfunction. ref:davidsson&;s principles and practices medicine,21 st ed,pg no 609