Question

A 60-year-old man with type 2 diabetes has an eGFR of 60 mL/min/1.73 m² and a urinary albumin-creatinine ratio of 8 mg/mmol on two occasions 3 months apart. Blood pressure is 136/80 mmHg on no medication. What is the most appropriate next step to reduce his risk of diabetic kidney disease progression and cardiovascular events?

Accepted Answer

Start an ACE inhibitor such as ramipril and titrate as tolerated

Answer

Reassure him that his kidney function is normal and no action is required

Answer

Start a thiazide diuretic for blood pressure control

Answer

Delay treatment until eGFR falls below 45 mL/min/1.73 m²

Answer

Commence long-term oral corticosteroids

Practice question