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CKD albuminuria RAAS therapy — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)CKD albuminuria RAAS therapyUSMLE Step 3

A 59-year-old woman with type 2 diabetes and chronic kidney disease returns for follow-up. Estimated GFR is 48 mL/min/1.73 m2, urine albumin-to-creatinine ratio is 420 mg/g, and blood pressure is 138/82 mm Hg. Potassium is 4.5 mEq/L. Which of the following would you recommend at the follow-up visit?

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Correct answer: D — Start an ACE inhibitor or angiotensin receptor blocker and monitor potassium and creatinine

Diabetes with CKD, hypertension, and albuminuria is an indication for ACE inhibitor or ARB therapy with renal function and potassium monitoring.

Reference: ADA Standards of Care in Diabetes