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Chronic kidney disease blood pressure — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Chronic kidney disease blood pressureUSMLE Step 3

A 66-year-old man with stage 3 chronic kidney disease has home blood pressures averaging 146/86 mm Hg. Urine albumin-creatinine ratio is 420 mg/g. Potassium is 4.3 mEq/L. He takes amlodipine 5 mg daily. Which of the following is the most appropriate at this time?

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

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Correct answer: D — Add an angiotensin receptor blocker and monitor potassium

Albuminuric CKD and hypertension should be treated with renin-angiotensin system blockade with monitoring of kidney function and potassium.

Reference: KDIGO CKD guideline: https://kdigo.org/