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CKD mineral bone disorder — USMLE Step 3 MCQ

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ModerateInternal Medicine (Chronic Management)CKD mineral bone disorderUSMLE Step 3

A 70-year-old man with CKD stage 4 has phosphate 5.8 mg/dL, calcium 9.2 mg/dL, and elevated parathyroid hormone. He eats processed foods daily. He has no symptoms. Which of the following would you recommend at the follow-up visit?

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

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Correct answer: D — Restrict dietary phosphate and consider phosphate binder therapy

CKD hyperphosphatemia is managed with dietary phosphate restriction and binders when needed.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials