skip to main content

ADPKD — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardPolycystic Kidney DiseaseADPKDESENeph

An adult without diabetes has eGFR 68 mL/min/1.73m² and a first urine ACR of 12 mg/mmol during a respiratory infection. How should albuminuria be confirmed under NICE NG203?

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

Reveal the answer and explanation

Correct answer: C — Repeat ACR in an early-morning urine sample

The best answer is “Repeat ACR in an early-morning urine sample”. NICE recommends confirming an initial ACR between 3 and 70 mg/mmol with a subsequent early-morning sample because intercurrent illness and biological variation can produce transient albuminuria. “Diagnose persistent albuminuria from this sample alone” overinterprets a single illness-associated result. “Replace ACR with a 24-hour urine sodium measurement” measures a different physiological variable. “Wait until eGFR falls below 45 mL/min/1.73m²” delays confirmation unnecessarily. “Confirm albuminuria using urine dipstick protein alone” is less sensitive and does not replace quantitative ACR confirmation.

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