Question

A 58-year-old with type 2 diabetes, albumin-to-creatinine ratio 420 mg/g, eGFR 28 mL/min/1.73 m², on ACE inhibitor. Next disease-modifying agent to slow CKD progression?

Accepted Answer

Start an SGLT2 inhibitor even at eGFR ≥20 mL/min/1.73 m²

Answer

Add thiazolidinedione for glycemic control

Answer

Switch ACE inhibitor to ARB

Answer

Add NSAID for proteinuria

Answer

Withhold additional therapy until eGFR <20

Practice question

A 58-year-old with type 2 diabetes, albumin-to-creatinine ratio 420 mg/g, eGFR 28 mL/min/1.73 m², on ACE inhibitor. Next disease-modifying agent to slow CKD progression?