Question

A 65-year-old man with diabetes and hypertension is found to have an eGFR of 52 mL/min/1.73 m² on two occasions 3 months apart and an ACR (albumin:creatinine ratio) of 45 mg/mmol. He is on an ACE inhibitor and his blood pressure is well controlled. What is the most appropriate management strategy?

Accepted Answer

Continue ACE inhibitor, optimise cardiovascular risk and monitor kidney function regularly

Answer

Stop the ACE inhibitor as it worsens kidney function

Answer

Start high-dose loop diuretics to improve eGFR

Answer

No further follow-up is required as eGFR is above 30 mL/min

Answer

Start long-term dialysis planning immediately

Practice question

A 65-year-old man with diabetes and hypertension is found to have an eGFR of 52 mL/min/1.73 m² on two occasions 3 months apart and an ACR (albumin:creatinine ratio) of 45 mg/mmol. He is on an ACE inhibitor and his blood pressure is well controlled. What is the most appropriate management strategy?