A 57-year-old man with type 2 diabetes has eGFR 58 mL/min/1.73 m2 and urine albumin-creatinine ratio 420 mg/g on two specimens. Blood pressure is

Question

A 57-year-old man with type 2 diabetes has eGFR 58 mL/min/1.73 m2 and urine albumin-creatinine ratio 420 mg/g on two specimens. Blood pressure is 142/82 mm Hg and potassium is 4.5 mEq/L. Which of the following is the most appropriate next step in management?

Accepted Answer

Start an ACE inhibitor or angiotensin receptor blocker

Answer

Stop glucose-lowering therapy immediately

Answer

Start high-protein diet for kidney protection

Answer

Order renal biopsy before treating blood pressure

Answer

Use loop diuretic as kidney-specific monotherapy

Chronic kidney disease albuminuria — USMLE Step 3 MCQ

A 57-year-old man with type 2 diabetes has eGFR 58 mL/min/1.73 m2 and urine albumin-creatinine ratio 420 mg/g on two specimens. Blood pressure is 142/82 mm Hg and potassium is 4.5 mEq/L. Which of the following is the most appropriate next step in management?