A 55-year-old man with type 2 diabetes has eGFR 55 mL/min/1.73 m² and urine albumin-creatinine ratio 50 mg/mmol. Blood pressure is 145/90 mmHg and he ...

Question

A 55-year-old man with type 2 diabetes has eGFR 55 mL/min/1.73 m² and urine albumin-creatinine ratio 50 mg/mmol. Blood pressure is 145/90 mmHg and he is not on antihypertensives. What is the most appropriate next step to slow renal progression and reduce cardiovascular risk?

Accepted Answer

Start an ACE inhibitor such as ramipril and target BP below 140/90 mmHg

Answer

Avoid ACE inhibitors because of his reduced eGFR

Answer

Start a loop diuretic such as frusemide

Answer

No treatment is required as his renal function is acceptable

Answer

Start an NSAID for analgesia of mild back pain

au-racgp MCQ (SBA): Diabetic nephropathy

A 55-year-old man with type 2 diabetes has eGFR 55 mL/min/1.73 m² and urine albumin-creatinine ratio 50 mg/mmol. Blood pressure is 145/90 mmHg and he is not on antihypertensives. What is the most appropriate next step to slow renal progression and reduce cardiovascular risk?