Ace the Certified Nephrology Nurse 2025 Exam – Dive into Dialysis Mastery!

Enalapril is commonly cleared by peritoneal dialysis (PD) because it is a medication that can be effectively removed from the bloodstream through this dialysis method. Enalapril, an angiotensin-converting enzyme (ACE) inhibitor used primarily for hypertension and heart failure, has a water-soluble characteristic that allows it to be excreted through the peritoneal cavity during dialysis.

In peritoneal dialysis, small molecules and drugs that are water-soluble can diffuse into the dialysis solution, which is then drained, effectively removing the medication from the patient's system. This is particularly important in patients with renal impairment, as their ability to excrete these substances is compromised.

Other medications listed, such as prednisone and digitoxin, are typically not cleared as effectively by PD due to their different solubility and binding properties. Prednisone is a steroid that is primarily metabolized by the liver and has a longer half-life, while digitoxin is a cardiac glycoside that is highly protein-bound and does not readily diffuse into the peritoneal dialysis fluid. Tobramycin, being an antibiotic, is more effectively cleared through hemodialysis due to its size and clearance characteristics. Therefore, enalapril stands out as