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Neurology — UKMLA MCQ

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HardNeurologyUKMLAMRCGP AKTMRCP Part 1

A non-diabetic adult with CKD takes the highest tolerated ACE-inhibitor dose. eGFR is 52 mL/min/1.73 m² and UACR is 18 mg/mmol on repeat testing. Which conclusion follows the current dapagliflozin appraisal?

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Correct answer: D — UACR must reach 22.6 mg/mmol in this eGFR branch

The best answer is “UACR must reach 22.6 mg/mmol in this eGFR branch”. TA1075 covers eGFR 20 to below 45 without an added albuminuria or diabetes gate. At eGFR 45 to 90, eligibility requires UACR at least 22.6 mg/mmol or type 2 diabetes. This non-diabetic patient has UACR 18, so the stated branch is not met. Background ACE-inhibitor or ARB therapy should be optimised unless contraindicated.

Reference: NICE TA1075, Dapagliflozin for chronic kidney disease: https://www.nice.org.uk/guidance/ta1075/chapter/1-Recommendations