A 62-year-old man with a 15-year history of type 2 diabetes has an eGFR of 48 mL/min/1.73 m² and urine albumin-creatinine ratio 35 mg/mmol despite goo...

Question

A 62-year-old man with a 15-year history of type 2 diabetes has an eGFR of 48 mL/min/1.73 m² and urine albumin-creatinine ratio 35 mg/mmol despite good blood pressure control on an ACE inhibitor. HbA1c is 7.4%. What is the most appropriate additional measure to reduce progression of diabetic kidney disease and cardiovascular risk?

Accepted Answer

Add an SGLT2 inhibitor

Answer

Cease ACE inhibitor due to reduced eGFR

Answer

Switch ACE inhibitor to a thiazide diuretic

Answer

Increase protein intake to maintain muscle mass

Answer

Avoid statin therapy due to reduced renal function

au-amc MCQ (SBA): Diabetic nephropathy