Abstract
Answer B. Optimise cardiovascular risk factors
This patient meets the diagnostic criteria for chronic kidney disease with a persistent glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and confirmed moderately increased albuminuria (albumin-to-creatinine ratio (ACR) 30–70 mg/mmol), classifying him as chronic kidney disease (CKD) stage G3a/A2. His kidney failure risk equation (KFRE) 5-year risk is below the 5% threshold for nephrology referral, so management should remain in primary care, focusing on optimisation of blood pressure (including angiotensin converting enzyme inhibitor titration), glycaemic control, lipid management and lifestyle measures to reduce cardiovascular and renal progression risk. Metformin remains safe at this eGFR, and loop diuretics are not indicated solely for albuminuria.
InnovAiT article: Stepwise management of chronic kidney disease in primary care. DOI: 10.1177/17557380261435934.
DOI: 10.1177/17557380261446499d