Question

A 54-year-old woman with long-standing type 2 diabetes and microalbuminuria (urinary albumin-creatinine ratio 4.5 mg/mmol) has blood pressure 132/82 mmHg and eGFR 70 mL/min/1.73 m². She is not currently on an ACE inhibitor or ARB. According to Australian diabetes management guidance, what is the most appropriate intervention regarding her kidney risk?

Accepted Answer

Start an ACE inhibitor even though her blood pressure is within target

Answer

No specific renal intervention is needed as blood pressure is normal

Answer

Start a thiazide diuretic to further lower blood pressure

Answer

Delay renin-angiotensin system blockade until eGFR falls below 60 mL/min/1.73 m²

Answer

Start an SGLT2 inhibitor only without ACE inhibitor or ARB

Practice question