Which therapy is recommended to decrease proteinuria in CKD?

Which therapy is recommended to decrease proteinuria in CKD?

• A. ACE inhibitors or ARBs
• B. High-protein diet
• C. Calcium channel blockers as first-line
• D. Beta-blockers only

Answer: (A)

Reducing proteinuria is a primary goal in CKD because ongoing loss of protein in the urine signals ongoing glomerular injury and predicts faster decline in kidney function. Blocking the renin-angiotensin system with ACE inhibitors or ARBs best achieves this reduction. By inhibiting angiotensin II, these drugs dilate the efferent arteriole, lowering intraglomerular pressure and the amount of protein that leaks into the urine. That decrease in proteinuria slows CKD progression and provides renal protection beyond just lowering blood pressure. While blood pressure control helps, the benefit here specifically comes from reducing intraglomerular hypertension and protein leakage. Other options don’t directly reduce proteinuria: a high-protein diet can worsen kidney injury; calcium channel blockers aren’t first-line for proteinuric protection; beta-blockers alone don’t reduce proteinuria.

Reducing proteinuria is a primary goal in CKD because ongoing loss of protein in the urine signals ongoing glomerular injury and predicts faster decline in kidney function. Blocking the renin-angiotensin system with ACE inhibitors or ARBs best achieves this reduction. By inhibiting angiotensin II, these drugs dilate the efferent arteriole, lowering intraglomerular pressure and the amount of protein that leaks into the urine. That decrease in proteinuria slows CKD progression and provides renal protection beyond just lowering blood pressure. While blood pressure control helps, the benefit here specifically comes from reducing intraglomerular hypertension and protein leakage. Other options don’t directly reduce proteinuria: a high-protein diet can worsen kidney injury; calcium channel blockers aren’t first-line for proteinuric protection; beta-blockers alone don’t reduce proteinuria.