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BP Target CKD Without Albuminuria — ESENeph MCQ

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HardHypertensionBP Target CKD Without AlbuminuriaESENeph

An adult with non-diabetic CKD has repeated clinic blood pressure 136/84 mmHg and ACR 82 mg/mmol on maximum tolerated RAS blockade. Which clinic target follows NICE NG203?

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

Reveal the answer and explanation

Correct answer: A — Target below 130/80 mmHg because ACR is at least 70 mg/mmol

Explanation lettering: E = shown as C · C = shown as E

A is correct. NICE uses the albuminuria threshold of 70 mg/mmol to set the lower CKD clinic target: systolic below 130 mmHg, target range 120–129, and diastolic below 80 mmHg. With ACR below 70, the target is below 140/90. These are clinic measurements using proper technique, not automatic targets for unstandardised home or research blood pressure. Frailty, orthostatic symptoms and multimorbidity still require judgement. Maximum tolerated RAS blockade does not remove the need to optimise other antihypertensive classes and sodium balance.

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