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Chronic kidney disease risk in Aboriginal health — RACP Adult Medicine MCQ

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HardAboriginal and Torres Strait Islander healthChronic kidney disease risk in Aboriginal healthRACP Adult Medicine

A 48-year-old Aboriginal woman in a remote community has type 2 diabetes, hypertension and urine albumin-creatinine ratio 38 mg/mmol on two samples. eGFR is 62 mL/min/1.73 m2. She has had fragmented follow-up because of travel and cultural obligations. What is the most appropriate management?

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Correct answer: B — Provide culturally safe CKD care with ACE inhibitor or ARB optimisation, diabetes therapy and recall support

Albuminuria in diabetes indicates CKD and high cardiovascular risk even when eGFR is preserved, requiring kidney-protective therapy and reliable culturally safe follow-up. Reassurance or delay misses a prevention window. Care should integrate cardiovascular risk and local Aboriginal health workforce support where available.

Reference: Kidney Health Australia CKD Management in Primary Care; NACCHO/RACGP guidance; AMH