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ACEi for Renoprotection — RACP Paediatrics MCQ

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ModerateNephrologyACEi for RenoprotectionRACP Paediatrics

A 7-year-old girl with a single functioning kidney (prior nephrectomy for Wilms tumour) has microalbuminuria detected on annual screening. What is the recommended first-line antihypertensive and renoprotective agent?

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

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Correct answer: B — ACE inhibitor (enalapril or ramipril)

ACE inhibitors are the first-line renoprotective agents for children with proteinuria/microalbuminuria and/or hypertension, especially in a single functioning kidney. They reduce intraglomerular pressure and proteinuria, slowing CKD progression. Monitoring of potassium and renal function is required.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: CKD