Question

A 64-year-old man with diabetes has an eGFR of 52 mL/min/1.73 m^2 and a urinary albumin:creatinine ratio of 45 mg/mmol on two occasions. Blood pressure is 146/88 mmHg. What is the most appropriate management regarding renin–angiotensin system blockade?

Accepted Answer

Start an ACE inhibitor for renoprotection and blood pressure control

Answer

No action is needed as his eGFR is above 30

Answer

Avoid ACE inhibitors because of chronic kidney disease

Answer

Use a calcium-channel blocker only

Answer

Refer immediately for dialysis

Practice question

A 64-year-old man with diabetes has an eGFR of 52 mL/min/1.73 m^2 and a urinary albumin:creatinine ratio of 45 mg/mmol on two occasions. Blood pressure is 146/88 mmHg. What is the most appropriate management regarding renin–angiotensin system blockade?