A 64-year-old man with chronic kidney disease has albumin-to-creatinine ratio 780 mg/g and estimated GFR 32 mL/min/1.73 m2. Blood pressure averages

Question

A 64-year-old man with chronic kidney disease has albumin-to-creatinine ratio 780 mg/g and estimated GFR 32 mL/min/1.73 m2. Blood pressure averages 152/86 mm Hg despite amlodipine. Potassium is 4.6 mEq/L. He has no renal artery stenosis. Which of the following is the most appropriate at this time?

Accepted Answer

Start an ACE inhibitor or ARB and monitor creatinine and potassium

Answer

Treat blood pressure if systolic exceeds 180 mm Hg

Answer

Start dual ACE inhibitor and ARB therapy

Answer

Avoid renin-angiotensin system blockade because albuminuria is present

Answer

Use NSAIDs for renal protection

Proteinuric chronic kidney disease hypertension — USMLE Step 3 MCQ

A 64-year-old man with chronic kidney disease has albumin-to-creatinine ratio 780 mg/g and estimated GFR 32 mL/min/1.73 m2. Blood pressure averages 152/86 mm Hg despite amlodipine. Potassium is 4.6 mEq/L. He has no renal artery stenosis. Which of the following is the most appropriate at this time?