Question

A 58-year-old man with CKD G3a and albuminuria A3 (UACR 560 mg/g) has standardized clinic SBP 138 mm Hg on no medications. Which is the best initial approach to BP and kidney protection?

Accepted Answer

Start an ACE inhibitor and target standardized SBP <120 mm Hg if tolerated

Answer

Target SBP <140 without RAAS blockade

Answer

Start thiazide diuretic; ACE inhibitor only if SBP >150

Answer

No pharmacologic therapy until UACR <300 mg/g

Answer

Start SGLT2 inhibitor only for albuminuria reduction; avoid ACE inhibitor

Practice question

A 58-year-old man with CKD G3a and albuminuria A3 (UACR 560 mg/g) has standardized clinic SBP 138 mm Hg on no medications. Which is the best initial approach to BP and kidney protection?