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CKD and Albuminuria Management — ESENeph MCQ

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ModerateNephrologyCKD and Albuminuria ManagementESENeph

A 62-year-old man with CKD G3a/A2 and hypertension is not on an ACE inhibitor or ARB. BP 142/86 on amlodipine alone. Best next step to slow CKD progression?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Add ACE inhibitor (or ARB) and titrate to maximum tolerated dose

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as D · D = shown as E

KDIGO recommends ACE inhibitor or ARB in patients with CKD and albuminuria (A2/A3) to reduce progression; titrate to maximally tolerated dose while monitoring creatinine and potassium. Thiazide (A) aids BP but does not replace RAAS blockade; beta blocker (D) and MRA (E) are not first add-ons for albuminuric CKD; (C) is incorrect.

Reference: KDIGO Guideline (2024): Evaluation and Management of Chronic Kidney Disease