CKD in Indigenous Australians — RACP Adult Medicine MCQ

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

ModerateNephrologyCKD in Indigenous AustraliansRACP Adult Medicine

A 55-year-old Aboriginal woman from remote Northern Territory presents with progressive renal impairment (eGFR 25 mL/min/1.73 m²). She has type 2 diabetes, hypertension, and albuminuria (ACR 120 mg/mmol). She is on maximum dose ramipril. Which additional agent has the strongest evidence for slowing CKD progression?

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

Reveal the answer and explanation

Correct answer: B — Dapagliflozin

SGLT2 inhibitors (dapagliflozin – DAPA-CKD trial; empagliflozin – EMPA-KIDNEY trial) have demonstrated a 39% relative risk reduction in CKD progression independent of diabetes status and down to eGFR 20 mL/min/1.73 m². They are now recommended as foundational therapy for CKD with albuminuria alongside RAS blockade. Aboriginal and Torres Strait Islander peoples have disproportionately high rates of CKD, and early intervention is critical.

Reference: KHA-CARI – 2024 – CKD in Aboriginal and Torres Strait Islander Peoples; KDIGO – 2024 – CKD Guideline