A 68-year-old man with stage 3 chronic kidney disease (eGFR 45 mL/min/1.73 m²) and type 2 diabetes is found to have an albumin:creatinine ratio of 45 ...

Question

A 68-year-old man with stage 3 chronic kidney disease (eGFR 45 mL/min/1.73 m²) and type 2 diabetes is found to have an albumin:creatinine ratio of 45 mg/mmol on two occasions. His blood pressure is 148/88 mmHg. He is not currently on a renin–angiotensin system blocker. What is the most appropriate next step in management?

Accepted Answer

Start an ACE inhibitor, titrating the dose as tolerated

Answer

Avoid ACE inhibitors because of chronic kidney disease

Answer

Start a thiazide diuretic only

Answer

Advise lifestyle changes only and monitor annually

Answer

Refer urgently for dialysis assessment

uk-plab-1 MCQ (SBA): Chronic kidney disease with albuminuria