A 59-year-old with T2DM, eGFR 48, and persistent albumin-creatinine ratio 320 mg/g despite ACE inhibitor and SGLT2 inhibitor asks about next steps to ...

Question

A 59-year-old with T2DM, eGFR 48, and persistent albumin-creatinine ratio 320 mg/g despite ACE inhibitor and SGLT2 inhibitor asks about next steps to slow CKD progression. Best addition?

Accepted Answer

Start finerenone

Answer

Add diltiazem for antiproteinuric effect

Answer

Stop ACE inhibitor to avoid hyperkalemia risk

Answer

Increase SGLT2 inhibitor dose above labeled maximum

Answer

Begin loop diuretic for renal protection

us-abim MCQ (SBA): Diabetic CKD (Finerenone)

A 59-year-old with T2DM, eGFR 48, and persistent albumin-creatinine ratio 320 mg/g despite ACE inhibitor and SGLT2 inhibitor asks about next steps to slow CKD progression. Best addition?