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Standardised vs Casual BP CKD — ESENeph MCQ

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HardHypertensionStandardised vs Casual BP CKDESENeph

A frail but independent 73-year-old with CKD G3b has casual clinic pressure 132/70 mmHg and a carefully standardised automated office systolic pressure of 116 mmHg, with postural dizziness. How should the KDIGO systolic target be applied?

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Correct answer: B — Standardised-result use with symptom-guided treatment review

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

D is correct. KDIGO’s suggested systolic target below 120 mmHg is tied to standardised office measurement and to tolerance. The patient is already below that target by the relevant method and has symptoms that make further intensification unsafe. A applies the target to a non-standardised value. B creates an unvalidated hybrid. C removes the explicit tolerance qualification and risks falls or hypoperfusion. E substitutes one unrepresentative home value for a validated protocol. Orthostatic measurements, drug indication, frailty and kidney trajectory should inform whether therapy needs reduction rather than reflex escalation.

Reference: KDIGO guideline for blood pressure in CKD: https://kdigo.org/guidelines/blood-pressure-in-ckd/