Question

A 62-year-old woman with type 2 diabetes and hypertension has newly detected persistent albuminuria (urine ACR 45 mg/mmol) and an eGFR of 55 mL/min/1.73 m². Blood pressure is 140/88 mmHg. Which single intervention is most important to slow progression of her kidney disease?

Accepted Answer

Start an ACE inhibitor or ARB and titrate to maximal tolerated dose

Answer

Start a thiazide diuretic

Answer

Start an ACE inhibitor even if BP is normal

Answer

Avoid all antihypertensives to preserve kidney perfusion

Answer

No treatment is required if eGFR is above 45

Practice question

A 62-year-old woman with type 2 diabetes and hypertension has newly detected persistent albuminuria (urine ACR 45 mg/mmol) and an eGFR of 55 mL/min/1.73 m². Blood pressure is 140/88 mmHg. Which single intervention is most important to slow progression of her kidney disease?