CKD Hypertension — ESENeph MCQ

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ModerateHypertensionCKD HypertensionESENeph

A 63-year-old woman with hypertension and CKD G3aA1 (eGFR 52 mL/min/1.73m2, uACR 2.5 mg/mmol) is on Amlodipine 10 mg. Her BP is 148/92 mmHg. What is the target BP and most appropriate medication change?

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Correct answer: B — Target <120 mmHg systolic; add an ACEi or ARB

KDIGO 2024 recommends targeting systolic BP <120 mmHg (measured using standardised office BP) in adults with CKD without diabetes (1B). For patients with diabetes, the target is also <120 mmHg systolic. Given no significant albuminuria (A1), an ACEi/ARB is not mandated but is a reasonable first-line choice. The key point is the new lower SBP target of <120 mmHg, applicable when tolerated.

Reference: KDIGO 2024 – Clinical Practice Guideline for CKD; KDIGO 2021 – Blood Pressure in CKD