A 68-year-old man with chronic kidney disease (eGFR 38 mL/min/1.73 m²) and long-standing hypertension has persistent albuminuria with urinary albumin:...

Question

A 68-year-old man with chronic kidney disease (eGFR 38 mL/min/1.73 m²) and long-standing hypertension has persistent albuminuria with urinary albumin:creatinine ratio 45 mg/mmol. His blood pressure is 146/88 mmHg on amlodipine 10 mg daily. Which change in therapy is most appropriate to reduce his cardiovascular and renal risk?

Accepted Answer

Add an ACE inhibitor and titrate to maximal tolerated dose

Answer

Switch amlodipine to a thiazide diuretic alone

Answer

Add low-dose aspirin without changing antihypertensive therapy

Answer

Add a non-dihydropyridine calcium-channel blocker instead of an ACE inhibitor

Answer

Cease amlodipine and commence beta blocker monotherapy

au-amc MCQ (SBA): Chronic kidney disease with albuminuria