Question

A 55-year-old with BMI 22 kg/m² and A1c 7.2% on metformin has microalbuminuria (ACR 55 mg/g) and eGFR 88. BP 138/86 mm Hg. Best next step for renal protection?

Accepted Answer

Start an ACE inhibitor (or ARB) and address BP to target

Answer

Add pioglitazone

Answer

No therapy until ACR >300 mg/g

Answer

Start loop diuretic

Answer

Stop metformin

Practice question

A 55-year-old with BMI 22 kg/m² and A1c 7.2% on metformin has microalbuminuria (ACR 55 mg/g) and eGFR 88. BP 138/86 mm Hg. Best next step for renal protection?