A 75-year-old man with a 2-year history of type 2 diabetes is noted to have persistent microalbuminuria (ACR 12 mg/mmol) on two consecutive tests. His...

Question

A 75-year-old man with a 2-year history of type 2 diabetes is noted to have persistent microalbuminuria (ACR 12 mg/mmol) on two consecutive tests. His eGFR is 72 mL/min/1.73m² and his blood pressure is 134/82 mmHg on Amlodipine 10 mg. According to NICE, what medication change is MOST appropriate?

Accepted Answer

Add Ramipril for its renoprotective effect in diabetic nephropathy with albuminuria

Answer

Continue Amlodipine alone as BP is at target

Answer

Switch to Doxazosin for better renal protection

Answer

Add Spironolactone as first-line for diabetic kidney disease

Answer

No change needed - ACR 12 is insignificant

uk-dgm MCQ (SBA): ACE Inhibitor for Diabetic Nephropathy

A 75-year-old man with a 2-year history of type 2 diabetes is noted to have persistent microalbuminuria (ACR 12 mg/mmol) on two consecutive tests. His eGFR is 72 mL/min/1.73m² and his blood pressure is 134/82 mmHg on Amlodipine 10 mg. According to NICE, what medication change is MOST appropriate?