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CKD Hypertension — ESENeph MCQ

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HardHypertensionCKD HypertensionESENeph

A 58-year-old without diabetes has persistent ACR 82 mg/mmol, microscopic haematuria and eGFR 52 mL/min/1.73m². Which referral decision follows NICE NG203?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Refer for specialist kidney assessment now

The best answer is “Refer for specialist kidney assessment now”. NICE recommends specialist referral for adults with ACR at least 70 mg/mmol unless the albuminuria is known to result from diabetes and is already appropriately treated. The accompanying haematuria reinforces the need for diagnostic assessment. The alternatives either delay indicated evaluation or escalate prematurely to kidney replacement planning.

Reference: NICE NG203 chronic kidney disease recommendations: https://www.nice.org.uk/guidance/ng203/chapter/Recommendations